Search

Background: Although exclusive breastfeeding is recommended for the first six months of life, research suggests that breastfeeding initiation rates and duration among Indigenous communities differ from this recommendation. Qualitative studies point to a variety of factors influencing infant feeding decisions; however, there has been no collective review of this literature published to date. Therefore, the objective of this scoping review was to identify and summarize the qualitative literature regarding Indigenous infant feeding experiences within Canada, the United States, Australia, and Aotearoa. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses- Scoping Reviews and the Joanna Briggs Institute Guidelines, in October 2020, Medline, Embase, CINAHL, PsycINFO, and Scopus were searched for relevant papers focusing on Indigenous infant feeding experiences. Screening and full-text review was completed by two independent reviewers. A grey literature search was also conducted using country-specific Google searches and targeted website searching. The protocol is registered with the Open Science Framework and published in BMJ Open. Results: Forty-six papers from the five databases and grey literature searches were included in the final review and extraction. There were 18 papers from Canada, 11 papers in the US, 9 studies in Australia and 8 studies conducted in Aotearoa. We identified the following themes describing infant feeding experiences through qualitative analysis: colonization, culture and traditionality, social perceptions, family, professional influences, environment, cultural safety, survivance, establishing breastfeeding, autonomy, infant feeding knowledge, and milk substitutes, with family and culture having the most influence on infant feeding experiences based on frequency of themes. Conclusions: This review highlights key influencers of Indigenous caregivers' infant feeding experiences, which are often situated within complex social and environmental contexts with the role of family and culture as essential in supporting caregivers. There is a need for long-term follow-up studies that partner with communities to support sustainable policy and program changes that support infant and maternal health. [ABSTRACT FROM AUTHOR]

Malnutrition and frailty affect up to one-third of community-dwelling older adults in Australia and New Zealand (ANZ), burdening individuals, health systems and the economy. As these conditions are often under-recognised and untreated in the community, there is an urgent need for healthcare professionals (HCPs) from all disciplines to be able to identify and manage malnutrition and frailty in this setting. This paper describes the systematic and iterative process by which a practical guide for identifying and managing malnutrition and frailty in the community, tailored to the ANZ context, was developed. The development of the guide was underpinned by the Knowledge-to-Action Framework and included the following research activities: (1) a comprehensive literature review; (2) a survey of ANZ dietitians' current practices and perceptions around malnutrition and frailty; (3) interviews with ANZ dietitians; and (4) a multidisciplinary expert panel. This resulted in the development of a guide tailored to the ANZ context that provides recommendations around how to identify and manage malnutrition and frailty in the community. It is now freely available online and can be used by all HCPs across several settings. The approach used to develop this guide might be applicable to other conditions or settings, and our description of the process might be informative to others who are developing such tools to guide practice in their healthcare environment. Malnutrition and frailty are common in Australian and New Zealand communities, burdening individuals, health systems and the economy. This paper describes the process by which an evidence-informed guide for identifying and managing these conditions in the community was developed. The guide is now freely available online and can be used by all healthcare professionals across several settings, and our description of the process might be informative to others who are developing such tools to guide practice in their healthcare environment. [ABSTRACT FROM AUTHOR]

Artificial Intelligence (AI) carries the potential for unprecedented disruption in radiology, with possible positive and negative consequences. The integration of AI in radiology holds the potential to revolutionize healthcare practices by advancing diagnosis, quantification, and management of multiple medical conditions. Nevertheless, the ever‑growing availability of AI tools in radiology highlights an increasing need to critically evaluate claims for its utility and to differentiate safe product offerings from potentially harmful, or fundamentally unhelpful ones. This multi‑society paper, presenting the views of Radiology Societies in the USA, Canada, Europe, Australia, and New Zealand, defines the potential practical problems and ethical issues surrounding the incorporation of AI into radiological practice. In addition to delineating the main points of concern that developers, regulators, and purchasers of AI tools should consider prior to their introduction into clinical practice, this statement also suggests methods to monitor their stability and safety in clinical use, and their suitability for possible autonomous function. This statement is intended to serve as a useful summary of the practical issues which should be considered by all parties involved in the development of radiology AI resources, and their implementation as clinical tools. [ABSTRACT FROM AUTHOR]

Community-based primary care, such as general practice (GP) or urgent care, serves as the primary point of access to healthcare for most Australians and New Zealanders. Coronavirus disease 2019 (COVID-19) has created significant and ongoing disruptions to primary care. Traditional research methods have contributed to gaps in understanding the experiences of primary care workers during the pandemic. This paper describes a novel research design and method that intended to capture the evolving impact of the COVID-19 pandemic on primary care workers in Australia and New Zealand. Recurrent, rapid cycle surveys were fielded from May 2020 through December 2021 in Australia, and May 2020 through February 2021 in New Zealand. Rapid survey development, fielding, triangulated analysis and dissemination of results allowed close to real-time communication of relevant issues among general practice workers, researchers and policy-makers. A conceptual model is presented to support longitudinal analysis of primary care worker experiences during the COVID-19 pandemic in Australia and New Zealand, and key learnings from applying this novel method are discussed. This paper will assist future research teams in development and execution of policy-relevant research in times of change and may inform further areas of interest for COVID-19 research in primary care. [ABSTRACT FROM AUTHOR]

An increasingly complex and demanding research landscape has seen university libraries rapidly evolve their services. While research data management, bibliometrics, and research impact services have predominantly featured in the literature to date, the full scope of support libraries are currently providing to their institutions is unknown. This paper aims to present an up-to-date view of the scope and extent of research support services by university libraries across Australia and Aotearoa New Zealand. A coding process analyzed content data from university library websites. Eleven research support areas were identified. Service delivery is split between synchronous and asynchronous modes. This paper describes a lived experience of an evidence-based library and information practice approach to improving research support services at two Australian university libraries, and while it highlights continued maturation of research support services, more research is needed to better understand influences on service development. [ABSTRACT FROM AUTHOR]

The centralisation of trauma services in western countries has led to an improvement in patient outcomes. Effective trauma systems include a pre‐hospital trauma system. Delivery of high‐level pre‐hospital trauma care must include identification of potential major trauma patients, access and correct application of lifesaving interventions (LSIs) and timely transport to definitive care. Globally, many nations endorse nationwide pre‐hospital major trauma triage guidelines, to ensure a universal approach to patient care. This paper examined clinical guidelines from all 10 EMS in Australia and Aotearoa/New Zealand. All relevant trauma guidelines were included, and key information was extracted. Authors compared major trauma triage criteria, all LSI included in guidelines, and guidelines for transport to definitive care. The identification of major trauma patients varied between all 10 EMS, with no universal criteria. The most common approach to trauma triage included a three‐step assessment process: physiological criteria, identified injuries and mechanism of injury. Disparity between physiological criteria, injuries and mechanism was found when comparing guidelines. All 10 EMS had fundamental LSI included in their trauma guidelines. Fundamental LSI included haemorrhage control (arterial tourniquets, pelvic binders), non‐invasive airway management (face mask ventilation, supraglottic airway devices) and pleural wall needle decompression. Variation in more advanced LSI was evident between EMS. Optimising trauma triage guidelines is an important aspect of a robust and evidence driven trauma system. The lack of consensus in trauma triage identified in the present study makes benchmarking and comparison of trauma systems difficult. Effective trauma systems include a pre‐hospital trauma system. Delivery of high‐level pre‐hospital trauma care must include identification of potential major trauma patients, access and correct application of lifesaving interventions (LSIs), and timely transport to definitive care. Authors compared major trauma triage criteria, all LSI included in guidelines, and guidelines for transport to definitive care, and identified variations between all systems included in the present study. [ABSTRACT FROM AUTHOR]

This perspective paper provides industry leaders, researchers and policy developers strategic approaches to ensure that the welfare of dairy cattle is protected at the same time as the industry increases its resilience to climate change. Farm systems and practices will evolve in response to the direct impacts of climate change and/or from responses to climate change, such as mitigation strategies to reduce dairy's greenhouse-gas (GHG) emissions. The five domains framework (nutrition, physical environment, health, behaviour, mental state) was used to assess the potential impacts on animal welfare and strategies to minimise these impacts are outlined. Given that the future climate cannot be certain these approaches can be applied under a range of emissions pathways to (1) ensure that the effects of GHG mitigations on animal welfare are considered during their development, (2) engage with end users and the public to ensure solutions to the effects of climate change and weather variability are accepted by consumers and communities, (3) identify and measure the areas where improved animal health can contribute to reducing GHG emissions from dairy production, (4) ensure those supporting farmers to develop and manage their farm systems understand what constitutes a good quality of life for dairy cattle, (5) ensure effective surveillance of animal disease and monitoring of welfare outcomes and farm-system performance in response to climate change and GHG mitigations. Overall, these strategies require a multidisciplinary co-development approach to ensure that the welfare of dairy cattle is protected at the same time as the industry increases its resilience to the wider impacts of a changing climate. [ABSTRACT FROM AUTHOR]

• The compressive behaviour of square RACFSST stub columns after exposure to fire is investigated. • Twelve post-fire compression tests are conducted. • The influences of heating durations and RCA replacement ratios are discussed. • Thermal and mechanical FE models are validated against test results and then used to conduct parametric studies. • The relevant design codes are assessed against the test and FE data. Experimental and numerical studies on the cross-section compressive behaviour and residual resistances of square recycled aggregate concrete-filled stainless steel tube (RACFSST) stub columns after exposure to fire are reported in this paper. An experimental programme was firstly carried out on twelve stub column specimens with three recycled coarse aggregate replacement ratios (0%, 35% and 70%) after exposure to the ISO-834 standard fire for 0 min (i.e. at ambient temperature), 15 min, 30 min and 45 min. The test results, including load–end shortening curves, failure loads and failure modes, were presented, with the initial compressive stiffness and confinement effect analysed. The experimental programme was followed by a numerical modelling programme, where thermal and mechanical finite element models were developed and validated against the test results and afterwards used to conduct parametric studies to generate additional numerical data over a wide range of cross-section dimensions. Based on the test and numerical data, the relevant design rules for square natural aggregate concrete-filled carbon steel tube stub columns at ambient temperature, as specified in the European code, Australia/New Zealand standard and American specification, were evaluated, using post-fire material properties, for their applicability to square RACFSST stub columns after exposure to fire. The evaluation results generally revealed that the European code and Australian/New Zealand standard led to a good level of design accuracy, while the American specification resulted in slightly conservative post-fire cross-section compression resistance predictions. [ABSTRACT FROM AUTHOR]

This paper presents experimental and numerical investigations into the post-fire cross-section compressive behaviour and resistances of circular recycled aggregate concrete-filled stainless steel tube (RACFSST) stub columns. Twelve stub column specimens, fabricated from concretes with three recycled coarse aggregate replacement ratios (0%, 35% and 70%), were tested after exposure to the ISO-834 standard fire for 0 min (i.e. at ambient temperature), 15 min, 30 min and 45 min. The experimental investigation included heating and cooling of specimens, cylinder tests and post-fire tensile coupon tests and stub column tests. The test results, including load–end shortening curves, failure loads and failure modes, were fully reported and the initial compressive stiffnesses and confinement effect were discussed. The numerical investigation was subsequently conducted, where thermal and mechanical finite element models were developed and validated against the test results and then used to perform parametric studies to generate further numerical data. Given the absence of design codes for stainless steel–recycled aggregate concrete composite structures after exposure to fire, the relevant design rules for circular natural aggregate concrete-filled carbon steel tube stub columns at ambient temperature, as set out in the European code, Australia/New Zealand standard and American specification, were assessed, using post-fire material properties, for their applicability to circular RACFSST stub columns after exposure to fire, based on the test and numerical data. The assessment results generally revealed that the European code and the Australian/New Zealand standard led to an acceptable level of design accuracy and consistency, while the American specification resulted in rather conservative and scattered post-fire cross-section compression resistance predictions. • The compressive behaviour of circular RACFSST stub columns after exposure to fire is investigated. • Post-fire compression tests on twelve circular RACFSST stub column specimens are conducted. • The influences of heating durations and RCA replacement ratios are analysed. • Thermal and mechanical FE models are validated against test results and then used to conduct parametric studies. • The relevant design codes are assessed against the test and FE data. [ABSTRACT FROM AUTHOR]