Heather Jarman

Multivitamin supplementation improves nutritional status and bone quality in aged care residents

Objectives:To assess the effectiveness of a multivitamin (MV) tablet on nutritional status, quantitative heel ultrasound (QUS), mobility, muscle strength and falls. The design comprised two groups matched on mobility levels, randomized to receive a daily MV or placebo (P) tablet for 6 months. The setting was an Australian residential care facility.Subjects:A total of 92 aged care residents. Serum micronutrients, body weight, QUS, rate of falls, hand grip strength, and the timed up and go test were assessed at baseline and 6 months.Results:A total of 49 participants consumed a MV and 43, a matched P for 6 months. There was a greater increase in the MV vs P group for serum 25(OH)D (mean difference±standard error, 33.4±2.6 nmol l−1), folate (13.4±2.8 nmol l−1), and vitamin B12 (178.0±40.3 pmol l−1) (all P<0.001). Adequate 25(OH)D concentrations (⩾50 nmol l−1) were found among 77% of participants in the MV group vs 10% taking P (P<0.001). Adjusting for baseline levels, the increase in QUS was greater in the MV vs P group (3.0±2.0 dB MHz−1 vs −2.9±2.1 dB MHz−1, respectively, P=0.041). There was a trend towards a 63% lower mean number of falls in the MV vs P group (0.3±0.1 falls vs 0.8±0.3 falls, P=0.078).Conclusions:MV supplementation raised serum vitamin B12 and folate concentrations and increased serum 25(OH)D, which was accompanied by an apparent positive effect on bone density. We also found a trend towards a reduction in falls and this could contribute to a reduction in fractures.

The early detection of Postpartum depression: Midwives and nurses trial a checklist

OBJECTIVE To evaluate the use of a standard pen-and-paper test versus the use of a checklist for the early identification of women at risk of postpartum depression and to investigate the experiences of nurses in using the checklist. DESIGN A prospective cohort design using repeated measures. SETTING The booking-in prenatal clinic at a regional hospital in Victoria, Australia, and the community-based postpartum maternal and child health service. PARTICIPANTS 107 pregnant women over 20 years of age. MAIN MEASURES Postpartum Depression Prediction Inventory (PDPI), Postpartum Depression Screening Scale (PDSS), Edinburgh Postnatal Depression Scale (EPDS), demographic questionnaire, and data on the outcome from the midwives and nurses. RESULTS The PDPI identified 45% of the women at risk of depression during pregnancy and 30% postpartum. The PDSS and EPDS both identified the same 8 women (10%), who scored highly for depression at the 8-week postpartum health visit. Nurses provided 80% of the women with anticipatory guidance on postpartum depression in the prenatal period and 46% of women at the 8-week postpartum health visit. Nurse counseling or anticipatory guidance was provided for 60% of the women in the prenatal period. CONCLUSION The PDPI was found to be a valuable checklist by many nurses involved in this research, particularly as a way of initiating open discussion with women about postpartum depression. It correlated strongly with both the PDSS and the EPDS, suggesting that it is useful as an inventory to identify women at risk of postpartum depression.

Private practice — An advanced practice option

Abstract Currently there is considerable debate on the role and function of nurses in Australia and internationally. This debate stems from developments within the nursing profession itself, from political and economic issues in health platforms, due to restructuring of the health care system, consumer expectations of health care and nurses’ expectations of a career. This paper provides the opportunity to reflect on the development of the role of the private practice (independent nurse) and where that role is situated in the nursing profession. This forms the basis for discussion of the development of specialty practice at an advanced level in Australia and to demonstrate its relationship with the nurse practitioner movement in Australia.