Data from four consecutive cohorts of students in Australia (2019-2022) show the impact of the COVID-19 pandemic on domestic and international university students' mental health

INTRODUCTION

COVID-19 and related travel and social restrictions caused significant stress for university students in Australia and globally. Learning quickly moved online and many students (particularly international students) were separated from social and economic support. This study examined the impact of the pandemic from pre-pandemic (2019) to the COVID-19 Omicron wave (2022) on domestic and international students' mental health.

METHODS

Participants were 1540 students (72% females, 28% international) in four first-year cohorts (2019, 2020, 2021, 2022). We screened for mental health concerns (% positive) and symptom scores for depression, anxiety and somatic distress using the PsyCheck, and general wellbeing using the Warwick-Edinburgh Mental Well-being scale.

RESULTS

From pre-COVID (2019) to the first wave of COVID-19 (2020), the proportion of students screening positive for mental health problems rose in both domestic students (66-76%) and international students (46-67%). Depression symptoms and wellbeing were worse in 2020 than in 2019, 2021 and 2022. Anxiety symptoms increased from 2019 to 2020 and continued to rise in 2021 and 2022. Somatic symptoms did not show an effect of cohort. Contrary to expectations, domestic students reported higher distress and lower wellbeing than international students across cohorts.

CONCLUSION

The pandemic was associated with a marked increase in psychological distress in first-year university students, not all of which settled with the easing of restrictions. Post-pandemic recovery in the Australian university sector must include university-wide access to mental health information and support for incoming students.

Pessary management practices for pelvic organ prolapse among Australian health care practitioners: a cross-sectional study

INTRODUCTION AND HYPOTHESIS

Vaginal pessaries are a low-cost, effective treatment for pelvic organ prolapse (POP) and an alternative to surgery. Whilst traditionally pessary management (PM) has been provided by medical professionals, particularly gynaecologists, recent international studies found other professionals, including physiotherapists and nurses, may be involved. It is unknown which health care practitioners (HCPs) provide PM for POP in Australia or the distribution of services.

METHODS

In a cross-sectional study design, a self-reported electronic survey investigated Australian HCPs providing PM for POP. Purposive and snowball sampling targeted HCPs, professional organisations and health care facilities. Descriptive statistics described PM in relation to HCP professional profile, PM provision and geographical location.

RESULTS

There were 536 respondents (324 physiotherapists, 148 specialists, 33 general practitioners (GPs) and 31 nurses providing PM. Most worked within metropolitan regions (n = 332, 64%), 140 (27%) in rural, 108 (21%) in regional and 10 (2%) in remote areas. Most worked privately (n = 418, 85%), 153 (46%) worked publicly and 85 (17%) in both. Ring pessaries were most commonly used, followed by cube and Gellhorn. HCPs reported variable training in PM, and 336 (69%) had no mandatory workplace competency standard; however, 324 (67%) wanted further training. Women travelled long distances to access services.

CONCLUSIONS

Doctors, nurses and physiotherapists provided PM in Australia. HCPs had variable training and experience in PM, with rural and remote HCPs particularly wanting further training. This study highlights the need for accessible PM services, standardised and competency-based training for HCPs, and governance structures ensuring safe care.

Understanding the Global Burden of Influenza in Adults Aged 18-64 years: A Systematic Literature Review from 2012 to 2022

INTRODUCTION

Adults aged 18-64 years comprise most of the working population, meaning that influenza infection can be disruptive, causing prolonged absence from the workplace, and reduced productivity and the ability to care for dependents. Influenza vaccine uptake is relatively low, even among the older adults in this population (i.e., aged 50-64 years), reflecting a lack of perceived need for vaccination. This systematic literature review (SLR) aimed to characterize the global burden of influenza in the 18-64 years population.

METHODS

An electronic database search was conducted and supplemented with conference and gray literature searches. Eligible studies described at least one of clinical, humanistic, or economic outcomes in adults aged 18-64 years and conducted across several global regions. Included studies were published in English, between January 1, 2012, and September 20, 2022.

RESULTS

A total of 40 publications were included, with clinical, humanistic, and economic outcomes reported in 39, 5, and 15, respectively. Risk of influenza-associated clinical outcomes were reported to increase with age among the 18-64 years population, including hospitalizations (Yamana et al. in Intern Med 60:3401-3408, 2021; Derqui et al. in Influenza Other Respir Viruses 16:862-872, 2022; Fuller et al. in Influenza Other Respir Viruses 16:265-275, 2022; Ortiz et al. in Crit Care Med 42:2325-2332, 2014; Yandrapalli et al. in Ann Transl Med 6:318, 2018; Zimmerman et al. in Influenza Other Respir Viruses 16:1133-1140, 2022). ICU admissions, mortality, ER/outpatient visits, and use of mechanical ventilation were recorded. Adults aged 18-64 years with underlying comorbidities were at higher risk of influenza-related hospitalizations, ICU admission, and mortality than otherwise healthy individuals. Length of hospital stay increased with age, although a lack of stratification across other economic outcomes prevented identification of further trends across age groups.

CONCLUSIONS

High levels of hospitalization and outpatient visits demonstrated a clinical influenza-associated burden on patients and healthcare systems, which is exacerbated by comorbidities. Considering the size and breadth of the general population aged 18-64 years, the limited humanistic and economic findings of this SLR likely reflect an underreported burden. Greater investigation into indirect costs and prolonged absenteeism associated with influenza infection is required to fully understand the economic burden in this population.

Foodservice systems and mealtime models in rehabilitation: Scoping review

AIMS

To describe current foodservice systems and mealtime care utilized in the rehabilitation setting. A secondary aim was to identify commonly used outcome measures in foodservice research in the rehabilitation setting.

DESIGN

A scoping review.

DATA SOURCES

PubMed, CINAHL, Scopus, Embase, PsycINFO and Cochrane were searched until January 2022.

REVIEW METHODS

The review was conducted according to Joanna Briggs Institute's methodology for scoping reviews. Included studies were conducted in the inpatient rehabilitation setting, adult population ≥18 years old and provided a description of at least one element of the foodservice system, food and menu, waste and/or eating environment.

RESULTS

Of 5882 articles screened, 37 articles were included, reporting 31 unique studies. Most rehabilitation units had cook-fresh production methods (50%), used decentralized bulk delivery methods (67%) had a communal dining room (67%) and had a 3-week menu cycle (71%). Mealtime care was predominantly provided by nursing staff, however few studies reported on specific activities. Nutritional intake was a key outcome measure across included studies (43%), with only six papers reporting on rehabilitation outcomes. Of the intervention studies (n = 9), all were aimed at improving nutritional intake through menu or mealtime care modifications; few (n = 3) studied changes in rehabilitation outcomes.

CONCLUSION

This scoping review identified a considerable lack of reporting of foodservice and mealtime care systems used in rehabilitation settings in the available literature. Further investigation is required to understand what models of mealtime care are provided to patients and to understand the impact of changes to foodservice and mealtime systems on patient outcomes.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution was necessary for this review.

Evaluating the Impact of Hydraulic Fracturing on Streams using Microbial Molecular Signatures

Hydraulic fracturing (HF), commonly called "fracking", uses a mixture of high-pressure water, sand, and chemicals to fracture rocks, releasing oil and gas. This process revolutionized the U.S. energy industry, as it gives access to resources that were previously unobtainable and now produces two-thirds of the total natural gas in the United States. Although fracking has had a positive impact on the U.S. economy, several studies have highlighted its detrimental environmental effects. Of particular concern is the effect of fracking on headwater streams, which are especially important due to their disproportionately large impact on the health of the entire watershed. The bacteria within those streams can be used as indicators of stream health, as the bacteria present and their abundance in a disturbed stream would be expected to differ from those in an otherwise comparable but undisturbed stream. Therefore, this protocol aims to use the bacterial community to determine if streams have been impacted by fracking. To this end, sediment, and water samples, from streams near fracking (potentially impacted) and upstream or in a different watershed of fracking activity (unimpacted) must be collected. Those samples are then subjected to nucleic acid extraction, library preparation, and sequencing to investigate microbial community composition. Correlational analysis and machine learning models can subsequently be employed to identify which features are explanative of variation in the community, as well as identification of predictive biomarkers for fracking's impact. These methods can reveal a variety of differences in the microbial communities among headwater streams, based on the proximity to fracking, and serve as a foundation for future investigations on the environmental impact of fracking activities.

Tecticornia sp. (Samphire)-A Promising Underutilized Australian Indigenous Edible Halophyte

Salinization is gradually increasing over cropping soils and is challenging Governments in many countries, including Australia. There has been a high demand for utilizing arid and semi-arid land for sustainable food production. Currently, the main crops and forage plants are salt sensitive, while halophytes can tolerate a wide range of salinities. Samphire is an Australian indigenous edible halophyte and belongs to the genus Tecticornia. It is an underutilized, succulent plant growing on arid or semi-arid land. Most samphire species have a long history of use as food, but also as non-food (fodder and medicine), among indigenous communities in Australia, while scientific information is limited on their nutritional composition and potential bioactivity. The present study reports, for the first time, the nutritional composition, bioactive compounds (phytochemicals) and antioxidant capacity of six Australian grown samphire from different locations. The results showed that celosianin II and isocelosianin II could be identified as the predominant betalains (phytochemicals) in pigmented samphire species. Proximates and fiber varied significantly (p < 0.05) between the samphire species with a highest value of fiber of 46.8 g/100 g dry weight (DW). Furthermore, samphire could be identified as a valuable source of essential minerals and trace elements, such as iron (41.5 mg/100 g DW), magnesium (1.2 g/100 g DW) and sodium (16.7 g/100 g DW). The fatty acid profile, mainly palmitic, stearic, oleic, linoleic and α-linolenic acid, was similar among the studied species. Total phenolic content and DPPH-radical scavenging capacity were different (p < 0.05) between the six samphire samples. These initial results are very promising and indicate that Australian grown samphire may have the potential to be utilized as a functional food ingredient.

A matter of taste: the adverse effect of pollen compounds on the pre-ingestive gustatory experience of sugar solutions for honeybees

In addition to sugars, nectar contains multiple nutrient compounds in varying concentrations, yet little is known of their effect on the reward properties of nectar and the resulting implications for insect behaviour. We examined the pre-ingestive responses of honeybees to sucrose solutions containing a mix of pollen compounds, the amino acids proline or phenylalanine, or known distasteful substances, quinine and salt. We predicted that in taste and learning assays, bees would respond positively to the presence of nutrient compounds in a sucrose solution. However, bees’ proboscis extension responses decreased when their antennae were stimulated with pollen- or amino acid-supplemented sucrose solutions. Compared to pure sucrose, bees exhibited worse acquisition when conditioned to an odour with pollen-supplemented sucrose as the unconditioned stimulus. Such learning impairment was also observed with quinine-containing sucrose solutions. Our results suggest that bees can use their antennae to detect pollen compounds in floral nectars. Depending on the type and concentrations of compounds present, this may result in nectar being perceived as distasteful by bees, making it less effective in reinforcing the learning of floral cues. Such reward devaluation might be adaptive in cases where plants benefit from regulating the frequency of bee visitation.

Challenges in the development of e-health strategies for geriatric medicine

Comprehensive geriatric assessment (CGA), supported by e-health, was provided to 89 frail veterans aged 70 years or older who were admitted to medical, surgical or orthopaedic units at two private hospitals in rural Queensland. Patients were screened and assessed by trained nurses using the interRAI-Acute Care tools. Data entry, validation, reporting and geriatrician comment were facilitated by an online, secure database and reporting system. The process was evaluated based on its utilization and staff satisfaction. The response to the project was generally very positive, but there were also some problems: (1) lack of staff, staff time and resources to successfully complete the assessments; (2) limited referrals from general practitioners (GPs) and difficulty with developing a sustainable communication and referral system between GPs and the hospital; (3) significant variations in caseloads between the study sites; and (4) the unfamiliarity of sufficient staff at the trial sites with the CGA process. Despite these challenges, the use of e-health-supported strategies in geriatric medicine certainly appears achievable and deserve further study.

Development of quality indicators for monitoring outcomes of frail elderly hospitalised in acute care health settings: study protocol

BACKGROUND

Frail older people admitted to acute care hospitals are at risk of a range of adverse outcomes, including geriatric syndromes, although targeted care strategies can improve health outcomes for these patients. It is therefore important to assess inter-hospital variation in performance in order to plan and resource improvement programs. Clinical quality outcome indicators provide a mechanism for identifying variation in performance over time and between hospitals, however to date there has been no routine use of such indicators in acute care settings. A barrier to using quality indicators is lack of access to routinely collected clinical data. The interRAI Acute Care (AC) assessment system supports comprehensive geriatric assessment of older people within routine daily practice in hospital and includes process and outcome data pertaining to geriatric syndromes. This paper reports the study protocol for the development of aged care quality indicators for acute care hospitals.

METHODS/DESIGN

The study will be conducted in three phases: 1. Development of a preliminary inclusive set of quality indicators set based on a literature review and expert panel consultation, 2. A prospective field study including recruitment of 480 patients aged 70 years or older across 9 Australian hospitals. Each patient will be assessed on admission and discharge using the interRAI AC, and will undergo daily monitoring to observe outcomes. Medical records will be independently audited, and 3. Analysis and compilation of a definitive quality indicator set, including two anonymous voting rounds for quality indicator inclusion by the expert panel.

DISCUSSION

The approach to quality indicators proposed in this protocol has four distinct advantages over previous efforts: the quality indicators focus on outcomes; they can be collected as part of a routinely applied clinical information and decision support system; the clinical data will be robust and will contribute to better understanding variations in hospital care of older patients; The quality indicators will have international relevance as they will be built on the interRAI assessment instrument, an internationally recognised clinical system.

A comparison of two measures of hospital foodservice satisfaction

There are few published papers on patient satisfaction with food or nutrition services in either acute or chronic health care settings. The aim of this study was to evaluate two questionnaires for measuring patient satisfaction with hospital foodservice, the "Parkside Inpatient Questionnaire" and the "Wesley Hospital Foodservice Patient Satisfaction Questionnaire". Data were collected from 540 patients at a Queensland Public Hospital.Results indicated the Wesley Hospital Foodservice Patient Satisfaction Questionnaire obtained more positive patient feedback and was more reliable at measuring patient satisfaction (?=0.89) than the Parkside Inpatient Questionnaire (?=0.75), thus it is a more effective foodservice quality management tool.

‘Abd al-Qādir al-Marāghī and ‘Alī b. Muḥammad Binā'ī: two fifteenth-century examples of notation. Part 1: Text

Given the dependence on aural transmission in the pre-modern musical traditions of the Islamic Middle East it is not at all surprising to find that compositions were hardly ever notated. If there is a typical method of recording the repertoire it is to be identified, rather, in the song-text anthology, which may provide quite detailed indications of formal structure but contains no melodic specification beyond identifying the principal mode of the piece and serves, therefore, as a textual prompt. Indeed, if we disregard as wholly exceptional the rich documentation of the Ottoman repertoire provided by the extensive collections of notated pieces made by ‘Alī Ufḳī and Cantemir, we find for the seventeenth and earlier centuries just one or two not very informative craps recorded by European observers and the occasional samples provided in theoretical treatises.

Rehabilitation after heart transplantation: the Australian experience

This study was designed to assess aspects of the quality of life and rehabilitation of heart transplant recipients who had transplantations at St. Vincent's Hospital, New South Wales, Australia, between February 1984 and March 1987. Factors determining return to full-time employment were delineated. A questionnaire was sent to 51 recipients. The response rate was 92%. The questionnaire measured employment status and satisfaction with family, social, marital, and sexual life. Financial status, exercise ability, and participation in daily activities were also assessed. Analysis showed that 53% of recipients had returned to either full-time or part-time employment, home duties, or full-time study. A further 28% were receiving a pension, 9% had chosen voluntary retirement, 6% were receiving unemployment benefits, and 4% were getting paid leave. Ability to exercise was improved for 77% of recipients and remained the same for another 14%. Financial status was unchanged for 45% and improved for 17%. Thirty-eight percent believed that they were worse off financially. Ratings of social, family, and marital life showed nearly complete or complete satisfaction in most cases. Satisfaction with sex life was less favorable. Comparison of the group who had returned to full-time employment with the group receiving a pension identified two variables of work status--length of time since transplantation and employment status before transplantation. There were also some differences between the two groups on quality of life ratings.