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The majority of Australian Aboriginal and Torres Strait Islander (hereafter referred to as "Aboriginal") people live in urban centres. Otitis media (OM) occurs at a younger age, prevalence is higher and hearing loss and other serious complications are more common in Aboriginal than non-Aboriginal children. Despite this, data on the burden of OM and hearing loss in urban Aboriginal children are limited. This project was initiated following a request from urban Aboriginal people who felt the focus on more remote communities often meant urban communities were forgotten. This paper describes the development of an urban Aboriginal birth cohort study of OM that is culturally secure, outlines the process of community consultation and establishment of an Aboriginal Community Advisory Group to provide cultural governance, and presents preliminary results. Djaalinj Waakinj is an ongoing study being conducted in Perth, Western Australia, on Noongar Boodja (country). Aboriginal researchers visit people's homes to collect sociodemographic and environmental data at enrolment of babies aged <3 months; otoscopy and tympanometry are conducted by an Aboriginal research assistant or a nurse at ages 2–4, 6–8 and 12–18 months, and full audiological assessment conducted at 9–12 months. To date, 125 participants have been enrolled; 39% of 71 children aged 2–4 months and 52% of 44 children aged 6–8 months had evidence of OM. To our knowledge, this is the first prospective cohort study aiming to determine the prevalence and risk factors associated with OM in Aboriginal infants residing in an urban area. [ABSTRACT FROM AUTHOR]

Background: Mass-casualty incidents (MCIs) are catastrophic. Whether they arise from natural or man-made disasters, the nature of such incidents and the multiple casualties involved can rapidly overwhelm response personnel. Mass-casualty triage training is traditionally taught via either didactic lectures or table top exercises. This training fails to provide an opportunity for practical application or experiential learning in immersive conditions. Further, large-scale simulations are heavily resource-intensive, logistically challenging, require the coordination and time of multiple personnel, and are costly to replicate. This study compared the simulation efficacy of a bespoke virtual-reality (VR) MCI simulation with an equivalent live simulation scenario designed for undergraduate paramedicine students. Methods: Both simulations involved ten injured patients resulting from a police car chase and shooting. Twenty-nine second-year paramedicine students completed the live and VR simulation in a random order. The training efficacy of the VR and live simulation was evaluated with respect to student immersion and task-difficulty, clinical decision-making (i.e. triage card allocation accuracy and timeliness), learning satisfaction, and cost of delivery. Results: While perceived physical demand was higher in the live simulation compared to VR (p < 0.001), no differences were observed across mental demand, temporal demand, performance, effort or frustration domains. No differences were found for participant satisfaction across the two platforms. No differences were observed in the number of triage cards correctly allocated to patients in each platform. However, participants were able to allocate cards far quicker in VR (p <.001). Cost of running the VR came to AUD $712.04 (staff time), compared to the live simulations which came to AUD $9,413.71 (staff time, moulage, actors, director, prop vehicle), approximately 13 times more expensive. Conclusion: The VR simulation provided near identical simulation efficacy for paramedicine students compared to the live simulation. VR MCI training resources represent an exciting new direction for authentic and cost-effective education and training for medical professionals. [ABSTRACT FROM AUTHOR]

Purpose: This study trialled a play-based, peer-to-peer intervention with children with autism spectrum disorder (ASD) to identify suitable instruments for measuring changes in pragmatic language following the intervention, and evaluate preliminary effectiveness. It also aimed to investigate the appropriateness of the intervention for participants. Method: Ten children with ASD, their typically developing peers, and parents participated. The Pragmatics Observational Measure (POM), Social Emotional Evaluation (SEE) and Profiling Elements of Prosody in Speech Communication (PEPS-C) measured the participant's social communication skills before, after, and 2-months following the intervention. Parent interviews were conducted two months after the intervention and responses were analysed using a thematic approach. Result: Children demonstrated gains in pragmatic language on the POM (χ2(3) = 11.160, p = 0.011) and related higher-level language on the SEE (χ2(2) = 6.686, p = 0.035). The PEPS-C did not produce any significant results. Parent interview responses indicated the intervention was appropriate for the children and families involved. Conclusion: The intervention warrants further investigation of effectiveness with a more robust research design. Consideration should be given to using observational measures of pragmatic language away from the clinic environment to evaluate generalisation, and future development of the intervention might consider variations in playmates and group size. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to demonstrate that opportunistic health screening at health expos can provide an overall impression of alcohol consumption patterns. Design: A repeated cross-sectional survey design, completed over a four-year period (2011-- 2014), was used to assess the risk of harmful alcohol consumption, within a community setting of older adults, in the South West region of Western Australia. Methods: An alcohol screening survey (AUDIT) was used to collect data on alcohol consumption patterns on those aged 65 years and over. A total of 411 surveys were completed. Results: There was a statistically significant difference in mean risk scores across the four years (p < .001). 6.3--22.2% of survey completers presented as 'risky', and a further 3.8-12.3% as 'high risk' in terms of alcohol consumption. Conclusions: Opportunistic screening for alcohol consumption during health expos can aid the identification of at-risk individuals who may require further education or treatment. [ABSTRACT FROM AUTHOR]

Fitness is an important component of health, and obese adolescents regularly have poor fitness. Unfortunately, few have assessed the impact of community-based lifestyle interventions on multiple components of fitness. The purpose of this study was to assess the impact of participation in a community-based intervention involving adolescents and parents on multiple components of fitness of obese adolescents. In a within-subject, waitlist controlled clinical trial with 12 months follow-up in Western Australia, participants (n = 56) completed multiple fitness measures at baseline, immediately prior to beginning an 8-week intervention and at 3, 6 and 12 months during a maintenance period. Performance on the shuttle walk was improved immediately post-intervention (increase of 42.8 m, 95% CI: 7.5, 78.2) and at 12 months post-intervention (increase of 44.6 m, 95% CI: 1.3, 87.8) compared with pre-intervention. Muscle performance of quadriceps and deltoids were improved post-intervention (increase of 1.1 (95% CI: 0.1, 2.1) kg · F and 1.0 (0.02, 2.1) kg · F, respectively) and all muscle performance measures were improved at 12 months following the intervention. There were no changes in waist circumference. A community-based lifestyle programme such as Curtin University’s Activity, Food and Attitudes Program (CAFAP) may be a viable strategy for improving fitness in overweight adolescents. [ABSTRACT FROM AUTHOR]

Background: Pre-drinking has been linked to subsequent heavy drinking and the engagement in multiple risky behaviors.Objectives: The present study examined a group of adolescents who recently had a “big night out” to determine whether there were differences in their pre-drinking behavior based on age, gender, geographic location, and social setting.Methods: Participants (n= 351, aged 16–19) representing the heaviest 20–25% of drinkers in their age group were recruited using nonrandom sampling from metropolitan (Melbourne, Sydney, Perth) or regional (Bunbury) locations across Australia and administered a survey by a trained interviewer.Results: Almost half the sample pre-drank (n= 149), most commonly at a friend's house. Those aged 18–19 were more likely to pre-drink, and did so at higher quantities compared to their younger counterparts. Males and females reported similar pre-drinking duration, quantity and amount spent on alcohol. Compared to those in cities, regional participants consumed greater quantities over longer periods of time. Two-thirds of participants consumed alcohol in excess of national guidelines during their pre-drinking session. These participants were more likely to nominate price as a motivation to pre-drink and were less likely to report that someone else provided them alcohol.Conclusions: This study sheds light on the pre-drinking habits of a population of young risky drinkers, and highlights the need for policy makers to address this form of drinking to reduce alcohol-related harm among young people. [ABSTRACT FROM PUBLISHER]

BackgroundThe Autism Detection in Early Childhood (ADEC) is a clinician-administered, Level 2 screening tool. A retrospective file audit was used to investigate its clinical effectiveness. MethodToddlers referred to an Australian child development service between 2008 and 2010 (N = 53,Mage = 32.2 months) were screened with the ADEC. Their medical records were reviewed in 2013 when their mean age was 74.5 months, and the original ADEC screening results were compared with later diagnostic outcomes. ResultsThe ADEC had good sensitivity (87.5%) and moderate specificity (62%). Three behaviours predicted autism spectrum disorders (ASDs): response to name, gaze switching, and gaze monitoring (p ≤ .001). ConclusionsThe ADEC shows promise as a screening tool that can discriminate between young children with ASDs and those who have specific communication disorders or developmental delays that persist into middle childhood but who do not meet the criteria for ASDs. [ABSTRACT FROM AUTHOR]

Despite a paucity of studies evaluating the psychometric properties of the Locus of Control of Behaviour Scale ( LCBS), it continues to be widely used in behavioural research. The present study sought to redress this gap in the literature. The 17-item LCBS was administered to 373 Australians attending Alcohol and Other Drug ( AOD) treatment agencies in the northern metropolitan region of Perth. Confirmatory factor analyses were conducted in order to determine which of several plausible measurement models provided the best fit for the data. A unidimensional model, recommended by the authors of the LCBS, and a two-dimensional (Internal Locus of Control vs External Locus of Control) model provided poor fits. Other multidimensional models, differing only in the dimensionality of the externality factor, were also tested. A multidimensional model consisting of an Internal Locus of Control factor and four component External Locus of Control factors provided the best fit; however, the fit is probably best described as 'reasonable' rather than 'good.' A subsequent exploratory factor analysis using parallel analysis indicated a cohesive internality factor; however, the externality factor showed a tendency to fragment into smaller components. Results were discussed in terms of the problematic externality factor. [ABSTRACT FROM AUTHOR]

Objective. Few empirical studies have specifically examined the relationship between socio-economic status (SES) and health in Indigenous populations of Australia. We sought to provide insights into the nature of this relationship by examining socio-economic disparities in physical health outcomes among Aboriginal and Torres Strait Islander children in Western Australia. Design. We used a diverse set of health and SES indicators from a representative survey conducted in 2000–2002 on the health and development of 5289 Indigenous children aged 0–17 years in Western Australia. Analysis was conducted using multivariate logistic regression within a multilevel framework. Results. After controlling for age and sex, we found statistically significant socio-economic disparities in health in almost half of the associations that were investigated, although the direction, shape and magnitude of associations differed. For ear infections, recurring chest infections and sensory function problems, the patterns were generally consistent with a positive socio-economic gradient – where better health was associated with higher SES. The reverse pattern was found for asthma, accidents and injuries, and oral health problems, although this was primarily observed for area-level SES indicators. Conclusion. Conventional notions of social position and class have some influence on the physical health of Indigenous children, although the diversity of results implies that there are other ways of conceptualising and measuring SES that are important for Indigenous populations. We need to consider factors that relate specifically to Indigenous circumstances and culture in the past and present day, and give more thought to how we measure social position in the Indigenous community, to gain a better understanding of the pathways from SES to Indigenous child health. [ABSTRACT FROM PUBLISHER]

Background: Few injecting drug users (IDU) in Australia take part in antiviral therapy for chronic hepatitis C (HCV). To assess whether IDU are aware of the eligibility criteria for treatment and their personal HCV status, we surveyed 78 IDU attending the fixed-site needle exchange in the city of Perth. Method: Participants were eligible for the study if they self-reported having ever been diagnosed as HCV antibody positive. Each participant completed a semi-structured questionnaire administered by a peer HCV educator at the needle exchange. Results: Knowledge of personal HCV status was poor with more than half of the group not knowing the purpose of a polymerase chain reaction test. Knowledge of treatment eligibility was also poor especially around issues relating to alcohol consumption, the need for a liver biopsy, and treatment during pregnancy. Conclusion: Up-to-date information about eligibility criteria for HCV treatment has not filtered down to this group of older IDU. Furthermore, knowledge of personal HCV status (chronic infection and infectivity) needs to be improved. Informed decisions about treatment cannot be made if knowledge of status is poor and IDU are not familiar with treatment eligibility. [ABSTRACT FROM AUTHOR]

Simulation is increasingly being used to prepare and supplement clinical practice in critical care areas for undergraduate Bachelor of Nursing (BN) students, with some success. However, the effects of multiple, medium-high fidelity simulations for this purpose have not been previously assessed. The purpose of this study was to assess self-reported confidence and competence using scenario-based simulations. A pre-test post-test design was used to evaluate a series of simulations conducted over a semester. There were twenty seven scenarios, incorporating programmed mannequins, moulage and actors. The scenarios were embedded in a team-based process involving preparation and video-recordings used for debriefing. Third year BN students reported their confidence and competence before and after the simulation series and made comments on their perception of the experience. Multiple scenario simulations are effective in improving BN students' confidence and competence related to critical care practice and are an enjoyable experience for students. [ABSTRACT FROM AUTHOR]