Active aging: Exploration into self-ratings of "being active," out-of-home physical activity, and participation among older Australian adults living in four different settings

We examined whether self-ratings of “being active” among older people living in four different settings (major city high and lower density suburbs, a regional city, and a rural area) were associated with out-of-home participation and outdoor physical activity. A mixed-methods approach (survey, travel diary, and GPS tracking over a one-week period) was used to gather data from 48 individuals aged over 55 years. Self-ratings of “being active” were found to be positively correlated with the number of days older people spent time away from home but unrelated to time traveled by active means (walking and biking). No significant differences in active travel were found between the four study locations, despite differences in their respective built environments.The findings suggest that additional strategies to the creation of “age-friendly” environments are needed if older people are to increase their levels of outdoor physical activity. “Active aging” promotion campaigns may need to explicitly identify the benefits of walking outdoors to ambulatory older people as a means of maintaining their overall health, functional ability, and participation within society in the long-term and also encourage the development of community-based programs in order to facilitate regular walking for this group.

Microscopy for the detection, identification and quantification of malaria parasites on stained thick and thin blood films in research settings

Summary This manual was developed to guide a move towards common standards for undertaking and reporting research microscopy for malaria parasite detection, identification and quantification. It contains procedures based on agreed quality assurance standards for research malaria microscopy defined at a consultation of: TDR, the Special Programme for Research and Training in Tropical Diseases; the Worldwide Antimalarial Resistance Network (WWARN), United Kingdom; the Foundation for Innovative New Diagnostics (FIND), Switzerland; the Centers for Disease Control and Prevention (CDC), USA; the Kenya Medical Research Institute (KEMRI) and later expanded to include Amref Health Africa (Kenya); the Eijkman-Oxford Clinical Research Unit (EOCRU), Indonesia; Institut Pasteur du Cambodge (IPC); Institut de recherche pour le Développement (IRD), Senegal; the Global Good and Intellectual Ventures Laboratory (GG-IVL), USA; the Mahidol-Oxford Tropical Medicine Research Unit (MORU), Thailand; Queensland University of Technology (QUT), Australia, and the Shoklo Malaria Research Unit (SMRU), Thailand. These collaborating institutions commit to adhering to these standards in published research studies. It is hoped that they will form a solid basis for the wider adoption of standardized reference microscopy protocols for malaria research.

A determinism and desire: Some neurological processes in perceiving the design object

The environment moderates behaviour using a subtle language of ‘affordances’ and ‘behaviour-settings’. Affordances are environmental offerings. They are objects that demand action; a cliff demands a leap and binoculars demand a peek. Behaviour-settings are ‘places;’ spaces encoded with expectations and meanings. Behaviour-settings work the opposite way to affordances; they demand inhibition; an introspective demeanour in a church or when under surveillance. Most affordances and behaviour-settings are designed, and as such, designers are effectively predicting brain reactions. • Affordances are nested within, and moderated by behaviour-settings. Both trigger automatic neural responses (excitation and inhibition). These, for the best part cancel each other out. This balancing enables object recognition and allows choice about what action should be taken (if any). But when excitation exceeds inhibition, instinctive action will automatically commence. In positive circumstances this may mean laughter or a smile. In negative circumstances, fleeing, screaming or other panic responses are likely. People with poor frontal function, due to immaturity (childhood or developmental disorders) or due to hypofrontality (schizophrenia, brain damage or dementia) have a reduced capacity to balance excitatory and inhibitory impulses. For these people, environmental behavioural demands increase with the decline of frontal brain function. • The world around us is not only encoded with symbols and sensory information. Opportunities and restrictions work on a much more primal level. Person/space interactions constantly take place at a molecular scale. Every space we enter has its own special dynamic, where individualism vies for supremacy between the opposing forces of affordance-related excitation and the inhibition intrinsic to behaviour-settings. And in this context, even a small change–the installation of a CCTV camera can turn a circus to a prison. • This paper draws on cutting-edge neurological theory to understand the psychological determinates of the everyday experience of the designed environment.

Becoming bilingual: Children’s insights about making friends in bilingual settings

The majority of the world speaks more than one language yet the impact of learning a second language has rarely been studied from a child’s perspective. This paper describes monolingual children’s insights into becoming bilingual at four time points: two months before moving to another country (while living in Australia), as well as one, six, and twelve months after moving to Germany. The participants were two monolingual English-speaking siblings (a male aged 7- to 8-years and a female aged 9- to 10-years) who subsequently learned to speak German. At each of the four time points, interviews were undertaken with each child using child-friendly drawing and questionnaire techniques. Three themes were identified: (1) the children’s awareness of language competence; (2) inclusion factors, and; (3) exclusion factors that influenced friendship formation. The impact of language ability on making friends was a dominant theme that arose across the four time points and was triangulated across data collection methods. The children made friends with others who had similar language competence in German, even though they were younger, and did not share the same first language. Age-matched peers who were more competent in German were less likely to be described as friends. Across all three themes, the playground was highlighted by both children as the key site where becoming bilingual most strongly impacted initiation and negotiation of friendships. Becoming bilingual impacted the children’s friendship formation and socialization opportunities with more competent language users.

‘True Blood’ the critical care story: An audit of blood sampling practice across three adult, paediatric and neonatal intensive care settings

Background Anaemia is common in critically ill patients, and has a significant negative impact on patients' recovery. Blood conservation strategies have been developed to reduce the incidence of iatrogenic anaemic caused by sampling for diagnostic testing. Objectives Describe practice and local guidelines in adult, paediatric and neonatal Australian intensive care units (ICUs) regarding blood sampling and conservation strategies. Methods Cross-sectional descriptive study, conducted July 2013 over one week in single adult, paediatric and neonatal ICUs in Brisbane. Data were collected on diagnostic blood samples obtained during the study period, including demographic and acuity data of patients. Institutional blood conservation practice and guidelines were compared against seven evidence-based recommendations. Results A total of 940 blood sampling episodes from 96 patients were examined across three sites. Arterial blood gas was the predominant reason for blood sampling in each unit, accounting for 82% of adult, 80% of paediatric and 47% of neonatal samples taken (p <. 0.001). Adult patients had significantly more median [IQR] samples per day in comparison to paediatrics and neonates (adults 5.0 [2.4]; paediatrics 2.3 [2.9]; neonatal 0.7 [2.7]), which significantly increased median [IQR] blood sampling costs per day (adults AUD$101.11 [54.71]; paediatrics AUD$41.55 [56.74]; neonatal AUD$8.13 [14.95]; p <. 0.001). The total volume of samples per day (median [IQR]) was also highest in adults (adults 22.3. mL [16.8]; paediatrics 5.0. mL [1.0]; neonates 0.16. mL [0.4]). There was little information about blood conservation strategies in the local clinical practice guidelines, with the adult and neonatal sites including none of the seven recommendations. Conclusions There was significant variation in blood sampling practice and conservation strategies between critical care settings. This has implications not only for anaemia but also infection control and healthcare costs.

Cost-effectiveness of hospital infection control interventions in resource-limited settings

The aim of this project was to evaluate the cost-effectiveness of hand hygiene interventions in resource-limited hospital settings. Using data from north-east Thailand, the research found that such interventions are likely to be very cost-effective in intensive care unit settings as a result of reduced incidence of methicillin-resistant Staphylococcus aureus bloodstream infection alone. This study also found evidence showing that the World Health Organization's (WHO) multimodal intervention is effective and when adding either goal-setting, reward incentives, or accountability strategies to the WHO intervention, compliance could be further improved.

Nursing care of children in general practice settings: roles and responsibilities

Aims. To examine roles and responsibilities of Practice Nurses in the area of child health and development and in advising parents about child health issues. Background. As the focus of Australia’s health care system shifts further towards the primary health care sector, governmental initiatives require that Practice Nurses are knowledgeable, confident and competent in providing care in the area of child health and development. Little is known about roles and responsibilities of Practice Nurses in this area. Design. Cross-sectional survey design. Methods. Practice Nurses completed a national online survey examining the roles and responsibilities in child health and development, professional development needs and role satisfaction. Data were collected from June 2010–April 2011. Results. Respondents (N = 159) reported having a significant role in well and sick child care and were interested in extending their role. Frequent activities included immunization, phone triage/advice, child health/development advice, wound care and Healthy Kids Checks. However, few had paediatric/child nursing backgrounds or postgraduate qualifications in paediatric nursing and they reported limited preparation for the role. Practice Nurses reported difficulties with keeping up-to-date with child health information and advising parents confidently. Satisfaction was relatively low regarding opportunities and encouragement to undertake professional development and expand scope of practice. Conclusion. Practice Nurses are largely unprepared to meet the demands of their child health role and need support to develop and maintain the skills and knowledge base necessary for high-quality, evidence-based practice. Both financial and time support is needed to enable Practice Nurses to access child health professional development.

Commercial friendships between gay sales associates and straight female customers in luxury settings: A proposed theoretical framework

This study investigates friendships between gay sales associates and heterosexual female customers in luxury retail settings. By employing grounded theory methodology, the study integrates theories and findings from diverse literature streams into an original conceptual framework to illustrate the resources gay sales associates and straight female customers receive from and provide to each other during retail exchanges. The study explains why gay male–straight female friendships are uniquely suited for luxury consumption settings. Female customers characterize their friendships with gay sales associates as providing honesty, security, trust, and comfort, which stems from the absence of sexual interest and a lack of inter-female competition. Gay sales associates receive acceptance for who they are and for their displays of unconventional masculinity in retail settings. They also obtain a temporary rite from their female customers, a so-called mandate of privacy, which permits both parties to ignore the bounds of modesty and accept a degree of intimacy. Such intimacy facilitates transactions that require both personalization and customer–employee closeness, such as the selling of high-end apparel, accessories, and jewelry.

Enhancing perceived fit on competitive settings

A common finding in the brand ex tension literature is that perceived fit has a directionally consistent impact on the extension evaluation. However, most of the literature ignores a more common marketplace reality, namely, competition. Drawing on categorization theory and on the notion t hat consumers evaluate brand extensions by a category - based processing, this research argues that consumers not only transfer quality perceptions about parent brand products from one category to another but also its competitive context and links. Results s how that when perceived rivalry between two brands in the parent category is transferred to the extension category, perceived favourability increases, regardless of the perceived fit between the parent brand and the extension category.

Challenges and opportunities in using wastewater analysis to measure drug use in a small prison facility

Introduction and Aims Wastewater analysis (WWA) is intended to be a direct and objective method of measuring substance use in large urban populations. It has also been used to measure prison substance use in two previous studies. The application of WWA in this context has raised questions as to how best it might be used to measure illicit drug use in prisons, and whether it can also be used to measure prescription misuse. We applied WWA to a small regional prison to measure the use of 12 licit and illicit substances. We attempted to measure the non-medical use of methadone and buprenorphine and to compare our findings with the results of the prison's mandatory drug testing (MDT). Design and Methods Representative daily composite samples were collected for two periods of 12 consecutive days in May to July 2013 and analysed for 18 drug metabolites. Prescription data and MDT results were obtained from the prison and compared with the substance use estimates calculated from WWA data. Results Daily use of methamphetamine, methadone, buprenorphine and codeine was detected, while sporadic detection of ketamine and methylone was also observed. Overall buprenorphine misuse appeared to be greater than methadone misuse. Discussion and Conclusions Compared with MDT, WWA provides a more comprehensive picture of prison substance use. WWA also has the potential to measure the misuse of medically prescribed substances. However, a great deal of care must be exercised in quantifying the usage of any substance in small populations, such as in prisons.

Doctor’s knowledge and practices of traumatic brain injury management in Chinese prehospital settings

Objectives: The incidence and mortality of traumatic brain injury (TBI) has increased rapidly in the last decade in China. Appropriate ambulance service can reduce case-fatality rates of TBI significantly. This study aimed to explore the factors (age, gender, education level, clinical experience, professional title, organization, specialty before prehospital care, and training frequency) that could influence prehospital doctors’ knowledge level and practices in TBI management in China, Hubei Province. Methods: A cross-sectional questionnaire survey was conducted in two cities in Hubei Province. The self-administered questionnaire consisted of demographic information and questions about prehospital TBI management. Independent samples t-test and one-way ANOVA were used to analyze group differences in the average scores in terms of demographic character. General linear regression was used to explore associated factors in prehospital TBI management. Results: A total of 56 questionnaires were handed out and 52 (93%) were returned. Participants received the lowest scores in TBI treatment (0.64; SD=0.08) and the highest scores in TBI assessment (0.80; SD=0.14). According to the regression model, the education level was associated positively with the score of TBI identification (P=.019); participants who worked in the emergency department (ED; P=.011) or formerly practiced internal medicine (P=.009) tended to get lower scores in TBI assessment; participants’ scores in TBI treatment were associated positively with the training frequency (P=.011); and no statistically significant associated factor was found in the overall TBI management. Conclusion: This study described the current situation of prehospital TBI management. The prehospital doctors’ knowledge level and practices in TBI management were quantified and the influential factors hidden underneath were explored. The results indicated that an appropriate continuing medical education (CME) program enables improvement of the quality of ambulance service in China.