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The objective of this study was to evaluate the effectiveness of drinking water quality verification monitoring as a means of improving preventive measures on drinking water quality management in regional New South Wales (NSW), Australia. Water sampling and E. coli detection data were obtained from the NSW Drinking Water Database. Statistical analysis was performed using Incidence Rate Ratios to compare the relationship between the proportion of samples collected to the tests allocated based on population served (sampling adequacy), E. coli detection and the relationship between sampling adequacy and E. coli detections over time. Sampling adequacy and E. coli detections significantly improved during the study period. Sampling adequacy was significantly lower in smaller populations (IRR = 0.83, p = 0.036). E. coli detections were significantly increased in smaller communities (IRR = 4.3, p = 0.01) and in summer (IRR = 2.7, p = < 0.001). There was a strong inverse correlation between improved sampling adequacy and decreased E. coli detections (Spearman's rho = −0.821; p < 0.0001). This research has highlighted the value of continued assistance to water utilities in the implementation of drinking water management systems to improve drinking water safety. [ABSTRACT FROM AUTHOR]

Recreational parks in the Hunter New England region of New South Wales, Australia, are very popular. Ensuring drinking water safety in the parks requires the application of a considered risk management approach. The study evaluated the compliance of public recreational parks with the NSW Public Health Act 2010 and NSW Public Health Regulation 2012 requirements to implement Quality Assurance Programs. Between March and August 2016, drinking water supplies in 54 national and three state recreational sites in regional Hunter New England were surveyed to evaluate whether the recommendations from the initial survey of 2010–2011 were implemented. The results were compared to the first survey results. All recreational sites developed and implemented drinking water quality assurance programs, compared to four during the first survey. Fifty two of 57 (91%) sites had warning signs at water outlets compared to 34 (60%) during the first survey. There were statistically significant improvements in the provision of water quality warning signs and implementation of water quality assurance programs (p < 0.0001 McNemar Chi2 Test) between the first and second surveys demonstrating a good example of beneficial policy change, with regulatory support. Further research is required to understand the ongoing challenges of drinking water management in recreational parks. [ABSTRACT FROM AUTHOR]

Balanced protein-energy supplementation can improve the nutritional status of pregnant women and birthweight. The cost of prenatal supplementation is often beyond the reach of mothers in low-income countries. In this study of undernourished pregnant women, the aim was to develop an affordable, locally produced, balanced protein-energy food-based supplement and test its acceptance. A small business enterprise was established. With a commitment to local-level applied research, a balanced protein-energy supplement was developed using locally available, affordable, and preferred foods. A 30-day acceptability study was conducted among 10 pregnant women between September and October 2012 in a rural district of northern Bangladesh. A questionnaire was administered at days 15 and 30 to assess women's perceptions and experience regarding compliance, organoleptic qualities, as well as personal and community attitudes toward the supplement and study. The primary outcome was compliance. All 10 women completed the 15- and 30-day questionnaires. The supplement was redeveloped at day 15 based on feedback from the follow-up survey and formal and informal feedback. By day 30, women consumed an average of 29.7 packets of the supplement of the 30 packets received. We concluded that the redeveloped locally produced food-based supplement was well accepted by pregnant women. Study findings have contributed toward the design of an efficacy trial currently underway. [ABSTRACT FROM AUTHOR]

Aim: This paper addresses the question of how social accountability is conceptualised by staff, students and community members associated with four medical schools aspiring to be socially accountable in two countries. Methods: Using a multiple case study approach this research explored how contextual issues have influenced social accountability at four medical schools: two in Australia and two in the Philippines. This paper reports on how research participants understood social accountability. Seventy-five participants were interviewed including staff, students, health sector representatives and community members. Field notes were taken and a documentary analysis was completed. Results: Overall there were three common understandings. Socially accountable medical education was about meeting workforce, community and health needs. Social accountability was also determined by the nature and content of programs the school implemented or how it operated. Finally, social accountability was deemed a personal responsibility. The broad consensus masked the divergent perspectives people held within each school. Conclusion: The assumption that social accountability is universally understood could not be confirmed from these data. To strengthen social accountability it is useful to learn from these institutions’ experiences to contribute to the development of the theory and practice of activities within socially accountable medical schools. [ABSTRACT FROM PUBLISHER]

Introduction: In a previous study consensus was sought from Malaysian occupational therapists of occupation-based intervention (OBI) that was perceived as a means and an end. Occupation as a means refers to occupational and purposeful tasks as a therapeutic agent while occupation as an end refers to occupation as an outcome of intervention. The purpose of this follow-up study was to describe the occupational therapists’ experiences of providing OBI in hand injury rehabilitation in Malaysia.Methods: Sixteen occupational therapists with more than five years of experience in hand rehabilitation were individually interviewed on their experiences of using OBI in practice. Data were thematically analysed using interpretative phenomenological analysis.Results: Definition of “Occupation as a means”, and “Occupation as an end” was broadened after data analysis of interviews to include two new themes: “Rewarding yet challenging” and “Making OBI a reality”. Occupational therapists had positive experiences with OBI and perceived that occupation as a means and an end can be merged into a single therapy session when the occupational therapists use an occupation that is therapeutic.Conclusion: Although occupation as a means and as an end have different purposes, when the ultimate goal is to enhance the clients’ maximum level of functioning both can be used for successful rehabilitation of hand injuries. [ABSTRACT FROM PUBLISHER]

The objective of this study was to assess whether the drinking water supplies in northern New South Wales (NSW) recreational parks conformed to the recommendations of the NSW Private Water Supply Guidelines. Water supplies in 57 recreational parks were surveyed to assess implementation of the Guidelines. A random sample of five parks (excluding reticulated town water supply or rainwater) was selected for microbiological sampling over a 12-month period. Additional nine samples were collected from carted water supplies. Forty-four of the 57 water supplies were untreated.Escherichia coliwas detected in 16 of 59 monthly samples. Two of 36 treated water samples showed contamination byE. colicompared to 14 of 23 untreated water samples. Three of nine carted water supplies hadE. coliat initial sampling. Thirty-four supplies had warning signs posted somewhere in the park. Twenty-one drinking water tanks had evidence of physical deterioration. No supply had a risk-based drinking water management plan. Treated water supplies had lower rates ofE. colidetection and presented a lower risk than untreated water supplies. Survey and sampling results indicated the need for reviewing existing water quality warning signs in the recreational parks and implementation of risk-based drinking water management plans. [ABSTRACT FROM PUBLISHER]

Introduction: This research explored the experience of receiving medical and rehabilitation intervention for rural and remote residents in North Queensland, Australia who had experienced a traumatic hand injury. This study contributes to larger project that seeks to propose a model of service delivery to rural and remote residents who have sustained a traumatic injury. Methods: Utilising an interpretive phenomenological research design, data was gathered through in-depth, semi-structured interviews. Fifteen participants were recruited into this study and questions were designed to explore the experience of receiving medical and rehabilitation intervention following a traumatic hand injury for residents in rural and remote areas of North Queensland. Results: The major themes that emerged were experience of medical intervention, experience of rehabilitation, travel, and technology. Participants felt that medical practitioners had a lack of local knowledge and were concerned that delays in medical intervention resulted in ongoing impairment. They reported following the exercise program they were given, often modifying it to fit with their daily routine. Metropolitan therapists appeared to have limited understanding of issues relevant to rural and remote lifestyles. There was, quite often, no occupational therapist or physiotherapist at their local facility due to staff turnover, and, when available, they had limited experience in hand injuries. The distance and cost of travel to appointments were of significant concern. The use of telehealth or telerehabilitation received a mixed response. Conclusion: Findings highlight the concerns regarding the provision of healthcare to rural and remote residents following a traumatic hand injury. These results provide the basis for recommendations surrounding the development of programs and service delivery models to address diverse needs in rural and remote areas. [ABSTRACT FROM AUTHOR]

Purpose: This feasibility study sought to determine if compliance and understanding of a home exercise program following a traumatic hand injury is improved when patients are provided with a DVD and a brochure when compared to using brochures only. Method: Patients who presented with a traumatic hand injury and commenced on a hand therapy protocol were randomly assigned into two groups. The control group received brochures while the experimental group were provided with exercise instructions on DVD as well as brochures. Compliance was measured through the use of exercise diaries, clinic attendance, a checklist to measure correctness and understanding of exercises and a follow-up survey. Results: No significant improvement was found in the mean exercise compliance score ( p = 0.344) between the intervention and control groups. From the survey results almost half of all participants reported that pain interfered in their ability to perform their home exercises and a third acknowledged that time limited their ability to perform their exercises. Conclusion: Findings demonstrate the multidimensional nature of compliance. The provision of DVD technology, while not shown to cause a statistically significant change in overall compliance, did help improve understanding of exercises; as such DVDs could be utilised as part of a program that facilitates the patient--therapist relationship. [ABSTRACT FROM AUTHOR]