Outcomes of an Australian Nursing Student-led School Vision and Hearing Screening Programme

Nursing students typically do not undertake clinical training in school settings. However, they are well placed to have a role in providing health screening and education in schools or community health venues under supervision of qualified nurses. This study provides a description and outcomes of a vision and hearing screening programme delivered by university nursing students working out of a student-led clinic situated in an underserved, largely Aboriginal and Torres Strait Islander community in regional Australia. Screening and follow-up data collected from 741 elementary school children indicated some important population patterns and trends, with nearly 30% having identified problems. Anecdotal evidence suggested children who gained treatment had improved school performance. Challenges to follow-up and confounding variables are discussed and a suggestion for future research is offered

High temperature X-ray diffraction and thermo-gravimetrical analysis of the cubic perovskite Ba0.5Sr0.5Co0.8Fe0.2O3-δ under different atmospheres

Ba0.5Sr0.5Co0.8Fe0.2O3−δ (BSCF) with the cubic perovskite structure is known to be metastable at low temperature under an oxidizing atmosphere. Here, the thermal and chemical expansion of BSCF were studied by in situ high temperature powder X-ray diffraction and thermo-gravimetrical analysis (TGA) in partial pressure of oxygen ranging from an inert atmosphere (∼10−4 bar) to 10 bar O2. The BSCF powder, heat treated at 1000 °C and quenched to ambient temperature prior to the analysis, was shown to oxidize under an oxidizing atmosphere before thermal reduction took place. With decreasing partial pressure of oxygen the initial oxidation was suppressed and only reduction of Co/Fe and loss of oxygen were observed under an inert atmosphere. The thermal expansion of BSCF under different atmospheres was determined from the thermal evolution of the cubic unit cell parameter, demonstrating that the thermal expansion of BSCF depends on the atmosphere. Chemical expansion of BSCF was also estimated based on the diffraction data and thermo-gravimetrical analysis. A hexagonal perovskite phase, coexisting with the cubic BSCF polymorph, was observed to be formed above 600 °C during heating. The phase separation leading to the formation of the hexagonal polymorph was driven by oxidation, and the unit cell of the cubic BSCF was shown to decrease with increasing amounts of the hexagonal phase. The hexagonal phase disappeared upon further heating, accompanied with an expansion of the unit cell of the cubic BSCFAuthor preprin

The intrinsically disordered Tarp protein from chlamydia binds actin with a partially preformed helix

Tarp (translocated actin recruiting phosphoprotein) is an effector protein common to all chlamydial species that functions to remodel the host-actin cytoskeleton during the initial stage of infection. In C. trachomatis, direct binding to actin monomers has been broadly mapped to a 100-residue region (726-825) which is predicted to be predominantly disordered, with the exception of a ~10-residue α helical patch homologous to other WH2 actin-binding motifs. Biophysical investigations demonstrate that a Tarp726-825 construct behaves as a typical intrinsically disordered protein; within it, NMR relaxation measurements and chemical shift analysis identify the ten residue WH2-homologous region to exhibit partial α-helix formation. Isothermal titration calorimetry experiments on the same construct in the presence of monomeric G-actin show a well defined binding event with a 1:1 stoichiometry and Kd of 102 nM, whilst synchrotron radiation circular dichroism spectroscopy suggests the binding is concomitant with an increase in helical secondary structure. Furthermore, NMR experiments in the presence of G-actin indicate this interaction affects the proposed WH2-like α-helical region, supporting results from in silico docking calculations which suggest that, when folded, this α helix binds within the actin hydrophobic cleft as seen for other actin-associated proteins

Chronic health and Lifestyle Problems for People Diagnosed with Autism in a Student-led Clinic

Purpose People with autism spectrum disorder (ASD) are at greater risk of developing chronic health and risky lifestyle problems. This is exaggerated further for people living in rural settings and from cultural backgrounds traditionally underserved by healthcare services. The purpose of this paper is to describe an evaluation of health and behavioural lifestyle outcomes of people diagnosed with ASD in a student-led clinic in rural/regional Australia. Design/methodology/approach Routine clinical outcomes and lifestyle measures were routinely collected at a primary acre student-led Clinic in rural/regional Australia. Participants were all attending the clinic who provided consent for their routine date to be reported. Participants ranged in age from new born to 100 years and were representative of the local community. Findings The results indicate there is an increased risk for people with ASD developing chronic conditions compared to those without a diagnosis. This also resulted in higher body mass index and blood sugar levels linked to diabetes and hypertension. Mental health problems were common in people diagnosed with ASD especially anxiety disorders. Smoking was problematic for people with ASD but mainly in non-Aboriginal and Torres Strait Islanders. Alcohol use was not an increase risk in ASD. Originality/value Little is reported on the health and lifestyle experiences of people with ASD in rural/regional settings, especially from Aboriginal and Torres Strait Islander communities. This paper gives an initial insight to the presentation of chronic conditions and harmful lifestyle choices. Possible insights into adapting or modifying care for people with ASD in rural/regional Australia are given. </jats:sec

Outcome of treatment seeking rural gamblers attending a nurse-led cognitive-behaviour therapy service: A pilot study

Copyright © 2016, Chinese Nursing Association. Production and hosting by Elsevier B.V.Objectives Little is known about the differences between urban and rural gamblers in Australia, in terms of comorbidity and treatment outcome. Health disparities exist between urban and rural areas in terms of accessibility, availability, and acceptability of treatment programs for problem gamblers. However, evidence supporting cognitive-behaviour therapy as the main treatment for problem gamblers is strong. This pilot study aimed to assess the outcome of a Cognitive-Behavioural Therapy (CBT) treatment program offered to urban and rural treatment-seeking gamblers. Methods People who presented for treatment at a nurse-led Cognitive-Behavioural Therapy (CBT) gambling treatment service were invited to take part in this study. A standardised clinical assessment and treatment service was provided to all participants. A series of validated questionnaires were given to all participants at (a) assessment, (b) discharge, (c) at a one-month, and (d) at a 3-month follow-up visit. Results Differences emerged between urban and rural treatment-seeking gamblers. While overall treatment outcomes were much the same at three months after treatment, rural gamblers appeared to respond more rapidly and to have sustained improvements over time. Conclusion This study suggests that rural problem gamblers experience different levels of co-morbid anxiety and depression from their urban counterparts, but once in treatment appear to respond quicker. ACBT approach was found to be effective in treating rural gamblers and outcomes were maintained. Ensuring better availability and access to such treatment in rural areas is important. Nurses are in a position as the majority health professional in rural areas to provide such help

Reliability and Validity of the Work and Social Adjustment Scale in Treatment-Seeking Problem Gamblers.

BACKGROUND: Problem gambling is a growing concern as governments become more reliant on gambling revenue particularly from increases in gambling casinos. It is widely reported that problem gamblers experience both high levels of comorbid mental health issues and subsequent disability that comes with such. To date, there have been few measures tested with problem gamblers that are a good measure of this disability. The Work and Social Adjustment Scale (WSAS) is a five-item measure of disability, which is used widely in a number of clinical settings including gambling. METHOD: The reliability and validity of the WSAS were examined in 171 outpatient problem gamblers who presented to a cognitive behavior therapy service in Adelaide, Australia. Subjects were assessed by trained cognitive behavior therapists and offered individual outpatient, group, or inpatient treatment. All subjects signed consent for their clinical data to be used and completed a battery of outcome measures at assessment, discharge, and 1-, 3-, and 6-month follow-up. RESULTS: The internal consistency of the WSAS was excellent among problem gamblers. A principal component analysis generated a single factor of disability. The WSAS has good concurrent validity with measures of gambling and comorbid anxiety and depression. The WSAS also shows promise as a measure of improvement in a clinical service. CONCLUSION: The WSAS has excellent reliability and sound validity among a treatment-seeking problem gambling population. Understanding disability related to gambling may offer insights into the long-term success of gamblers completing treatment. This instrument needs further refinement in a more rigorous experimental setting

Cognitive-behavior therapy for problem gambling: a critique of current treatments and proposed new unified approach

This is an Accepted Manuscript of an article published by Taylor & Francis in the Journal of Mental Health on 18 October 2016, available online: http://www.tandfonline.com/10.1080/09638237.2016.1207235 BACKGROUND: There is evidence supporting the use of cognitive-behavioral therapy (CBT) in the treatment of problem gambling. Despite this, little is known about how CBT works and which particular approach is most effective. This paper aims to synthesize the evidence for current CBT and propose a more unified approach to treatment. METHODS: A literature review and narrative synthesis of the current research evidence of CBT for the treatment of problem gambling was conducted, focusing on the underlying mechanisms within the treatment approach. RESULTS: Several CBT approaches were critiqued. These can be divided into forms of exposure therapy (including aversion techniques, systematic desensitization and other behavioral experiments) those focusing on cognitive restructuring techniques (such as reinforcement of nongambling activity, use of diaries, motivational enhancement and audio-playback techniques and third wave techniques including mindfulness. Findings, in relation to the treatment actions, from this synthesis are reported. CONCLUSIONS: The debate surrounding the treatment of problem gambling has been conducted as an either/or rather than a both/and discourse. This paper proposes a new, unified approach to the treatment of problem gambling that incorporates the best elements of both exposure and cognitive restructuring techniques, alongside the use of techniques borrowed from mindfulness and other CBT approaches

The impact of gambling on rural communities worldwide: A narrative literature review

Gambling has become a popular activity in both urban and rural settings. Although the prevalence and participation of gambling is well known, little has been reported regarding the impacts of gambling on rural communities. Therefore, a narrative literature review approach was adopted to examine what is known regarding gambling in rural communities. This article describes the prevalence and types of gambling that are popular in rural communities around the world. It identifies the benefits and highlights the potential harm caused by a person’s gambling and the impact this has on families and the wider rural community. There are both benefits and risks associated with increased availability of gambling opportunities. Specific vulnerable groups within rural populations are identified within this context and how different countries respond to rural gambling is explored. A number of strategies based on a public health approach are recommended to ensure that gambling remains as harmless an activity as possible in rural communities. (PsycINFO Database Record (c) 2016 APA, all rights reserved

Cognitive-behavior therapy for problem gambling: a critique of current treatments and proposed new unified approach

This is an Accepted Manuscript of an article published by Taylor & Francis in the Journal of Mental Health on 18 October 2016, available online: http://www.tandfonline.com/10.1080/09638237.2016.1207235 BACKGROUND: There is evidence supporting the use of cognitive-behavioral therapy (CBT) in the treatment of problem gambling. Despite this, little is known about how CBT works and which particular approach is most effective. This paper aims to synthesize the evidence for current CBT and propose a more unified approach to treatment. METHODS: A literature review and narrative synthesis of the current research evidence of CBT for the treatment of problem gambling was conducted, focusing on the underlying mechanisms within the treatment approach. RESULTS: Several CBT approaches were critiqued. These can be divided into forms of exposure therapy (including aversion techniques, systematic desensitization and other behavioral experiments) those focusing on cognitive restructuring techniques (such as reinforcement of nongambling activity, use of diaries, motivational enhancement and audio-playback techniques and third wave techniques including mindfulness. Findings, in relation to the treatment actions, from this synthesis are reported. CONCLUSIONS: The debate surrounding the treatment of problem gambling has been conducted as an either/or rather than a both/and discourse. This paper proposes a new, unified approach to the treatment of problem gambling that incorporates the best elements of both exposure and cognitive restructuring techniques, alongside the use of techniques borrowed from mindfulness and other CBT approaches