ORCID Profile
0000-0002-8217-317X
Current Organisations
Wayne State University
,
University of Tasmania
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Publisher: Oxford University Press (OUP)
Date: 17-07-2020
Abstract: aspiration pneumonia increases hospitalisation and mortality of older people in residential aged care. determine potentially pathogenic microorganisms in oral specimens of older people with aspiration pneumonia and the effect of professional oral care in reducing aspiration pneumonia risk. PUBMED/MEDLINE, CINAHL, EMBASE, COCHRANE, PROQUEST, Google Scholar, Web of Science. published between January 2001 and December 2019 addressing oral microorganisms, aspiration pneumonia, oral health and treatment. people 60 years and older in residential aged care. the Newcastle–Ottawa Scale and the Standard Protocol Items: Recommendations for Intervention Trials checklist. twelve studies (four cross-sectional, five cohort and three intervention) reported colonisation of the oral cavity of older people by microorganisms commonly associated with respiratory infections. Aspiration pneumonia occurred less in people who received professional oral care compared with no such care. Isolation of Candida albicans, Staphylococcus aureus, methicillin-resistant S. aureus and Pseudomonas aeruginosa was related to mortality due to aspiration pneumonia. An interesting finding was isolation of Escherichia coli, a gut bacterium. more information may be present in publications about other co-morbidities that did not meet inclusion criteria. A high degree of heterogeneity prevented a meta-analysis. Issues included s ling size, no power and effect size calculations different oral health assessments how oral specimens were analysed and how aspiration pneumonia was diagnosed. pathogenic microorganisms colonising the oral microbiome are associated with aspiration pneumonia in older people in residential care professional oral hygiene care is useful in reducing aspiration pneumonia risk.
Publisher: Springer Science and Business Media LLC
Date: 26-12-0001
Publisher: Informa UK Limited
Date: 08-2010
Publisher: Wiley
Date: 24-10-2019
DOI: 10.1111/AJR.12556
Abstract: To describe the characteristics of hospital admissions for dental conditions, by Australian Statistical Geography Standard remoteness area for the 5 years 2010/2011 to 2014/2015. Retrospective analysis of preventable hospital admissions due to dental conditions. National data set provided by the Australian Institute of Health and Welfare. Every hospital admission for patients who were admitted for dental conditions over five financial years, from 2010/2011 to 2014/2015. The number (and rate per 1000 population) of hospital admissions due to dental conditions in each Australian Statistical Geography Standard remoteness area (major city, inner regional, outer regional, remote and very remote). There were 316 937 hospital admissions for dental conditions over the 5-year period. The rate of potentially preventable dental hospital admissions ranged from an average of 2.5 per 1000 population in major cities to 3.2 in inner regional areas, 3.1 in outer regional areas, and 4.1 per 1000 in remote and very remote areas. The rate of admissions was highest among those aged 0-14 years living in remote (9.0-10.0 per 1000) and very remote (9.8-12.5 per 1000) areas. Dental caries was the most common reason for admissions. There is an urgent need to address the social determinants of oral health in children aged 0-14 years living in remote and very remote Australia. The delivery of mobile primary dental care services needs to be expanded in remote and very remote areas to prevent and treat dental caries.
Publisher: Routledge
Date: 26-07-2018
Publisher: Elsevier BV
Date: 10-2012
Publisher: Scitechnol Biosoft Pvt. Ltd.
Date: 2016
Publisher: Openventio Publishers
Date: 31-08-2015
DOI: 10.17140/OROJ-2-113
Publisher: Informa UK Limited
Date: 08-2017
DOI: 10.2147/AMEP.S115321
Publisher: Wiley
Date: 09-08-2018
DOI: 10.1111/IJN.12692
Abstract: To evaluate the nutritional status and needs of a person with dementia living in an aged care home, including identification of barriers to, and effective strategies for, the provision of person-centred care. Nutrition and hydration care are integral to quality of life for adults with dementia, but there is little research on whether staff knowledge around effective care strategies for residents is translated into optimal care. Focused ethnographic single-case design. The perspectives of the resident, her prime family member, and six care staff were triangulated through interviews, observation, document audit, and medical file review to investigate the resident's nutrition and hydration status and needs (October 2014-April 2015). During 3 years in care, this resident had lost weight steadily. Staff appeared attentive but did not maintain a systematic record of body mass index. At meals, staff encouraged eating but used ineffective strategies. Food was not served in ways that facilitated active participation. Eating and drinking were structured as tasks to be completed rather than activities to be enjoyed. This instrumental case study identified a task-oriented, rather than person-centred, approach to nutrition and hydration care, adversely affecting the resident's nutritional health and capability to participate actively.
Publisher: American Speech Language Hearing Association
Date: 10-2014
DOI: 10.1044/AIHE17.2.47
Abstract: Students who aspire to a career in health care need to be educated in the practical requirements of effective health care. These requirements are premised on understanding the perspective of the patient, appreciating and respecting the contributions of the range of the professions involved in health care, and being able to work and communicate effectively with all stakeholders. These competencies are best achieved through interprofessional, case-based education. The positive outcomes of students' experiences in the national CLARION competition stimulated the development of a series of interprofessional, case-based seminars to expose more students to this valuable form of experiential learning. This paper provides an ex le of how faculty from different professions can work together to develop their own case-based seminars using standardized patients to provide students with valuable interprofessional learning and research opportunities. Both the steps involved in the development and implementation of the seminars and lessons learned are described for faculty seeking interprofessional simulation experiences for students.
Publisher: Informa UK Limited
Date: 30-03-2016
DOI: 10.3109/13561820.2015.1117061
Abstract: This report describes the outcomes of a five-day, protocol-based interprofessional education (IPE) initiative to prepare undergraduate medical, nursing, and paramedic students for collaborative work with adults with dementia. Clinical placements provided a structured and supervised IPE experience for 127 students in two Residential Aged Care Facilities (RACFs) in Hobart, Australia, during 2013 and 2014. The IPE activity was based on a seven-step protocol formulated by an interprofessional team of educators and aged care practitioners that revolved around collaborative assessments of adults with complex health needs. This article describes the IPE protocol and presents the results of a pre- and post-placement attitude questionnaire and knowledge quiz administered to evaluate student attitudes towards IPE and knowledge of dementia. Data suggest that a five-day, supervised, and protocol-based IPE experience in a dementia-care setting can inculcate positive changes in student attitudes about collaborative practice and may encourage dementia-related learning outcomes.
Publisher: Informa UK Limited
Date: 13-02-2014
DOI: 10.3109/17549507.2014.882989
Abstract: The sensory and gastrointestinal changes that occur with ageing affect older adults' food and liquid intake. Any decreased liquid intake increases the risk for dehydration. This increased dehydration risk is compounded in older adults with dysphagia. The availability of a non-invasive and easily administered way to document hydration levels in older adults is critical, particularly for adults in residential care. This pilot study investigated the contribution of bioelectrical impedance analysis to measure hydration in 19 older women in residential care: 13 who viewed themselves as healthy and six with dysphagia. Mann-Whitney U analyses documented no significant between-group differences for Total Body Water (TBW), Fat Free Mass (FFM), Fat Mass (FM), and percentage Body Fat (%BF). However, when compared to previously published data for age-matched women, the TBW and FFM values of the two participant groups were notably less, and FM and %BF values were notably greater than expected. If results are confirmed through continued investigation, such findings may suggest that long-term care facilities are unique environments in which all older residents can be considered at-risk for dehydration and support the use of BIA as a non-invasive tool to assess and monitor their hydration status.
Publisher: Springer Science and Business Media LLC
Date: 18-07-2022
DOI: 10.1186/S12883-022-02772-5
Abstract: The worldwide prevalence of dementia is rapidly rising. Alzheimer’s disease (AD), accounts for 70% of cases and has a 10–20-year preclinical period, when brain pathology covertly progresses before cognitive symptoms appear. The 2020 Lancet Commission estimates that 40% of dementia cases could be prevented by modifying lifestyle/medical risk factors. To optimise dementia prevention effectiveness, there is urgent need to identify in iduals with preclinical AD for targeted risk reduction. Current preclinical AD tests are too invasive, specialist or costly for population-level assessments. We have developed a new online test, TAS Test, that assesses a range of motor-cognitive functions and has capacity to be delivered at significant scale. TAS Test combines two innovations: using hand movement analysis to detect preclinical AD, and computer-human interface technologies to enable robust ‘self-testing’ data collection. The aims are to validate TAS Test to [1] identify preclinical AD, and [2] predict risk of cognitive decline and AD dementia. Aim 1 will be addressed through a cross-sectional study of 500 cognitively healthy older adults, who will complete TAS Test items comprising measures of motor control, processing speed, attention, visuospatial ability, memory and language. TAS Test measures will be compared to a blood-based AD biomarker, phosphorylated tau 181 (p-tau181). Aim 2 will be addressed through a 5-year prospective cohort study of 10,000 older adults. Participants will complete TAS Test annually and subtests of the Cambridge Neuropsychological Test Battery (CANTAB) biennially. 300 participants will undergo in-person clinical assessments. We will use machine learning of motor-cognitive performance on TAS Test to develop an algorithm that classifies preclinical AD risk (p-tau181-defined) and determine the precision to prospectively estimate 5-year risks of cognitive decline and AD. This study will establish the precision of TAS Test to identify preclinical AD and estimate risk of cognitive decline and AD. If accurate, TAS Test will provide a low-cost, accessible enrichment strategy to pre-screen in iduals for their likelihood of AD pathology prior to more expensive tests such as blood or imaging biomarkers. This would have wide applications in public health initiatives and clinical trials. ClinicalTrials.gov Identifier: NCT05194787 , 18 January 2022. Retrospectively registered.
Publisher: Informa UK Limited
Date: 10-10-2014
DOI: 10.3109/13561820.2014.969835
Abstract: This study analyzed students' written reflections following their initial exposure to interprofessional teamwork in case-based problem-solving. A three-hour seminar featuring three sequenced scenarios was developed and offered 12-times over two semesters. A total of 305 students from a variety of healthcare programs worked together with standardized patients in an on-c us laboratory simulating hospital ward and rehabilitation settings. A thematic analysis of students' reflections showed that they valued the shared learning and realistic case study. However, they felt the experience would be strengthened by working in smaller, more representative teams that included students from medicine, psychology, and social work to enable more effective communication and comprehensive case discussion. While useful for future planning, the identified themes did not enable a comparative statistical analysis of what students found helpful and difficult and a re-coding of students' responses now is underway. Implications for measuring the effectiveness of future interprofessional case-based learning center on addressing the identified weaknesses, and establishing a research design that enables a comparison of pre- and post-seminar data, and the effectiveness of the IPE experience compared to profession-specific experiences.
Publisher: Springer Science and Business Media LLC
Date: 22-01-2015
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2013
Publisher: BMJ
Date: 10-2023
Publisher: SAGE Publications
Date: 06-08-2014
Abstract: Interprofessional education (IPE) is recognized as a critical component in preparing students for effective interprofessional practice in health care. IPE is supported by the American Speech-Language-Hearing Association and students’ competence in interprofessional practice is expected by clinical supervisors for effective work in any setting, whether that setting is medically or educationally oriented. IPE thus needs to be integrated into the curriculum of academic programs in Communication Sciences and Disorders and supported by clinicians in the field. This short tutorial is designed to acquaint readers with the concept of IPE, the collaborative competencies that students develop, available learning models, the importance of measuring the effectiveness of any interprofessional intervention, and ongoing challenges that need to be addressed to facilitate the implementation of this valuable learning strategy.
Publisher: Springer International Publishing
Date: 2016
Publisher: Informa UK Limited
Date: 2012
DOI: 10.1080/02701960.2012.639101
Abstract: The health care needs of older adults can be complex and multifaceted. Safe, effective, equitable, and person-centered service provision relies on skilled interprofessional, team-based practice. Too often, students seeking a career specializing in gerontology are not exposed to such interprofessional, team-based learning and practice during their coursework. This article details the core interprofessional collaborative competencies that need to be an integral component of any program providing quality education on issues in aging.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2012
Publisher: Springer Science and Business Media LLC
Date: 05-06-2023
DOI: 10.1186/S12912-023-01366-X
Abstract: The oral health of many older Australians is poor and associated with many systemic health problems. However, nurses often have a limited understanding of the importance of oral healthcare for older people. This study aimed to investigate Australian nursing students’ perception, knowledge, and attitude toward providing oral healthcare for older people and associated factors. A cross-sectional study was conducted among final year nursing students studying at accredited nursing programs using an online self-reported 49-item survey. The data were analysed using univariate and bivariate analysis ( t -test, ANOVA, Spearman’s correlation test). A total of 416 final-year nursing students from 16 accredited programs in Australia completed the survey. Mean scores showed that more than half of the participants felt they lacked confidence (55%, n = 229) and had limited knowledge about oral healthcare for older people (73%, n = 304) however, their attitude towards providing such care was favourable (89%, n = 369). A positive correlation was found between students’ confidence in delivering oral healthcare to older people and their perceived knowledge ( r = 0.13, p 0.01). Results revealed a statistically significant positive association between students’ experience in providing oral healthcare to older people and students’ perception ( t = 4.52, p 0.001), knowledge ( t = 2.87, p 0.01), and attitude ( t = 2.65, p 0.01) mean scores in such care. Nearly 60% (n = 242) of participants received education/training in oral healthcare for older people at university, but this was often for less than one hour. Around 56% (n = 233) believed that the current nursing curriculum did not prepare them to provide effective oral healthcare to older people. Findings suggested a need for nursing curricula to be revised to include oral health education and clinical experience. Knowledge of evidence-based oral healthcare by nursing students may improve the quality of oral healthcare for older people.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2013
Publisher: MDPI AG
Date: 20-10-2021
Abstract: Restraint use in Australian residential aged care has been highlighted by the media, and investigated by researchers, government and advocacy bodies. In 2018, the Royal Commission into Aged Care selected ‘Restraint’ as a key focus of inquiry. Subsequently, Federal legislation was passed to ensure restraint is only used in residential aged care services as the ‘last resort’. To inform and develop Government educational resources, we conducted qualitative research to gain greater understanding of the experiences and attitudes of aged care stakeholders around restraint practice. Semi-structured interviews were held with 28 participants, comprising nurses, care staff, physicians, physiotherapists, pharmacists and relatives. Two focus groups were also conducted to ascertain the views of residential and community aged care senior management staff. Data were thematically analyzed using a pragmatic approach of inductive and deductive coding and theme development. Five themes were identified during the study: 1. Understanding of restraint 2. Support for legislation 3. Restraint-free environments are not possible 4. Low-level restraint 5. Restraint in the community is uncharted. Although most staff, health practitioners and relatives have a basic understanding of restraint, more education is needed at a conceptual level to enable them to identify and avoid restraint practice, particularly ‘low-level’ forms and chemical restraint. There was strong support for the new restraint regulations, but most interviewees admitted they were unsure what the legislation entailed. With regards to resources, stakeholders wanted recognition that there were times when restraint was necessary and advice on what to do in these situations, as opposed to unrealistic aspirations for restraint-free care. Stakeholders reported greater oversight of restraint in residential aged care but specified that community restraint use was largely unknown. Research is needed to investigate the extent and types of restraint practice in community aged care.
Publisher: GRF Publishers Pty Ltd
Date: 20-07-2021
DOI: 10.53634/100030
Publisher: Longwoods Publishing
Date: 28-11-2014
Publisher: Longwoods Publishing
Date: 28-11-2014
Publisher: Wiley
Date: 04-10-2017
DOI: 10.1111/JOCN.14066
Abstract: To examine awareness of aged care home staff regarding daily food and fluid care needs of older people with dementia. Older people in residential care frequently are malnourished, and many have dementia. Staff knowledge of the food and fluid needs of people with dementia is limited. Qualitative research on this topic is scarce but can provide insight into how nutrition and hydration care may be improved. Qualitative, interview-based study. Eleven staff in a range of positions at one care home were interviewed regarding their perceptions of current and potential food/fluid care practices. Transcripts were coded and analysed thematically. Key food and fluid issues reported by these staff members were weight loss and malnutrition, chewing and swallowing difficulties (dysphagia), and inadequate hydration. Staff identified a number of current care practices that they felt to be effective in facilitating older people's food and fluid intake, including responsiveness to their needs. Staff suggestions to facilitate food and fluid intake centred on improved composition and timing of meals, enhanced physical and social eating environment, and increased hydration opportunities. Staff commented on factors that may prevent changes to care practices, particularly the part-time workforce, and proposed changes to overcome such barriers. Staff were aware of key food and fluid issues experienced by the older people in their care and of a range of beneficial care practices, but lacked knowledge of many promising care practices and/or how to implement such practices. Staff need to be supported to build on their existing knowledge around effective food and fluid care practices. The numerous ideas staff expressed for changing care practices can be leveraged by facilitating staff networking to work and learn together to implement evidence-based change.
Publisher: Springer Science and Business Media LLC
Date: 14-07-2020
DOI: 10.1186/S12912-020-00454-6
Abstract: The recognised relationship between oral health and general health, the rapidly increasing older population worldwide, and changes in the type of oral health care older people require have raised concerns for policymakers and health professionals. Nurses play a leading role in holistic and interprofessional care that supports health and ageing. It is essential to understand their preparation for providing oral health care. Objective: To synthesise the evidence on nursing students’ attitudes towards, and knowledge of, oral healthcare, with a view to determining whether oral health education should be incorporated in nursing education. Data sources : Three electronic databases - PubMed, Scopus, and CINAHL. Study eligibility criteria, participants and interventions: Original studies addressing the research objective, written in English, published between 2008 and 2019, including students and educators in undergraduate nursing programs as participants, and conducted in Organisation of Economic Co-operation and Development countries. Study appraisal and synthesis methods: Data extracted from identified studies were thematically analysed, and quality assessment was done using the Mixed Methods Appraisal Tool. From a pool of 567 articles, 11 met the eligibility criteria. Findings documented five important themes: 1.) nursing students’ limited oral health knowledge 2.) their varying attitudes towards providing oral health care 3.) the need for further oral health education in nursing curricula 4.) available learning resources to promote oral health and 5.) the value of an interprofessional education approach to promote oral health care in nursing programs. Limitations: The identified studies recruited small s les, used self-report questionnaires and were conducted primarily in the United States. The adoption of an interprofessional education approach with a focus on providing effective oral health care, particularly for older people, needs to be integrated into regular nursing education, and practice. This may increase the interest and skills of nursing students in providing oral health care. However, more rigorous studies are required to confirm this. Nursing graduates skilled in providing oral health care and interprofessional practice have the potential to improve the oral and general health of older people.
Publisher: Elsevier BV
Date: 10-2018
Publisher: MDPI AG
Date: 24-08-2021
DOI: 10.20944/PREPRINTS202108.0466.V1
Abstract: Restraint use in Australian residential aged care has been highlighted by the media, and investigated by researchers, government and advocacy bodies. In 2018, the Royal Commission into Aged Care selected & lsquo Restraint& rsquo as a key focus of inquiry. Subsequently, Federal legislation was passed to ensure restraint is only used in residential aged care services as the & lsquo last resort& rsquo . To inform and develop Government educational resources, we conducted qualitative research to gain greater understanding of the experiences and attitudes of aged care stakeholders around restraint practice. Semi-structured interviews were held with 28 participants, comprising nurses, care staff, doctors, physiotherapists, pharmacists and relatives. Two focus groups were also conducted to ascertain the views of residential and community aged care senior management staff. Data were thematically analyzed using a pragmatic approach of inductive and deductive coding and theme development. Five themes were identified during the study: 1. Understanding of restraint 2. Support for Legislation 3. Restraint-free environments are not possible 4. Low-level restraint, and 5. Restraint in the community is uncharted. Although most staff, health practitioners and relatives have a basic understanding of restraint, more education is needed at a conceptual level to enable them to identify and avoid restraint practice, particularly & lsquo low-level& rsquo forms and chemical restraint. There was strong support for the new restraint regulations, but most interviewees admitted they were unsure what the legislation entailed. With regards to resources, stakeholders wanted recognition that there were times when restraint was necessary and advice on what to do in these situations, as opposed to unrealistic aspirations for restraint-free care. Stakeholders reported greater oversight of restraint in residential aged care but stated that community restraint use was largely unknown. Research is needed to investigate the extent and types of restraint practice in community aged care.
Publisher: Elsevier BV
Date: 07-2019
DOI: 10.1016/J.PUHE.2019.02.018
Abstract: Aboriginal people and Torres Strait Islanders are impacted by dementia at higher rates and at a younger age of onset than the broader Australia population. Public health strategies to support this population require a thorough understanding of how Aboriginal people perceive dementia and dementia care support needs. The aim of this study was to investigate Aboriginal community understandings of dementia and their responses to dementia care. This study is a community participatory action research partnership. The mixed method study was undertaken in 2017 with members of a discrete Aboriginal community from rural Tasmania, Australia. Participants were older than 18 years, self-identified as an Aboriginal person and were living or had lived in the community studied. Data were derived from 50 participants who completed the 27-item Dementia Knowledge Assessment Scale (DKAS). Twelve of these participants also shared their dementia care experiences in in idual interviews. The DKAS results showed a low overall level of dementia knowledge, with a total mean score of 27.73 (scoring 51% on average) of a possible score of 54. The salient interview theme was the cultural obligation to care for family members living with dementia. Dementia care metaphors represented ways to protect family members living with dementia and maintain their ongoing connections to home and community. However, limited understandings of dementia affected their capacity to provide quality care. The findings contribute to public health scholarship involving Aboriginal community responses to dementia care. The study has resulted in important initiatives including a community-based dementia education program to ensure Aboriginal people impacted by dementia are provided with effective and culturally appropriate care.
Start Date: 2018
End Date: 2019
Funder: Tasmanian Community Fund
View Funded ActivityStart Date: 2016
End Date: 2017
Funder: Dementia Collaborative Research Centre
View Funded ActivityStart Date: 2019
End Date: 2021
Funder: Medical Research Future Fund
View Funded ActivityStart Date: 2017
End Date: 2017
Funder: University of Tasmania
View Funded Activity