Rosemary Cant

Effects of diet and exercise on plasma vitamin D (25(OH)D) levels in Vietnamese immigrant elderly in Sydney, Australia

Vitamin D deficiency may be associated with osteoporosis and fractures in the elderly. In Australia where there is a sizeable Vietnamese population, research has not yet clarified the roles of diet, exercise and sun exposure in determining vitamin D status. Plasma samples for 25-hydroxy-vitamin D (25(OH)D); dietary intake of vitamin D and calcium; muscle strength and sun exposure were measured and weekly dairy intake, exercise levels and smoking habits were surveyed in free-living elderly of Vietnamese and Australian/British origin. There was marginal vitamin D deficiency (<37 nmol/L 25(OH)D) in 63% of Vietnamese but only in 37% of Australian/British born. Low dairy intake and no vigorous exercise were best predictors of vitamin D deficiency in Vietnamese, taking into account age, gender, dietary intake and sun exposure. Since these migrant elderly may not get adequate sun exposure due to either clothing customs or cultural norms that encourage fair (untanned) skin, it is important to encourage increased exercise and dairy intake.

The Relationship Between Obesity and Blood Pressure Differs by Ethnicity in Sydney School Children

BACKGROUND The objective of this study was to investigate the relationship between obesity and high systolic blood pressure (SBP) in Southeast Asian (SEAsian) and Australian children living in Australia. METHODS SBP, country of birth, and obesity indices (body mass index (BMI), waist circumference (WC), and percent body fat (%TBF)) were recorded in 1,232 9-year-old children from Sydney schools and remeasured 3 years later (n = 628). The relationship between SBP and obesity (both at baseline and longitudinally) was investigated by regression analyses. RESULTS Children of SEAsian origin had a significantly higher risk of high SBP with increases in obesity indices compared to those of Australian origin. At 9 years old, SBP increased 1.51 mm Hg for each of BMI increase for SEAsian children compared to 1.05 mm Hg for Australian children (P(interaction) = 0.03). These same significant analysis of variance (ANOVA) interactions were seen with WC (P(interaction) = 0.02) and %TBF (P(interaction) = 0.04) as predictors of SBP. These differences by ethnic background were also reflected in the 3-year longitudinal analysis where SEAsian children showed higher risk of increasing SBP with BMI increase (SBP increased 1.70 mm Hg for each unit of BMI increase for SEAsian children compared to 0.80 mm Hg for Australian children (P(interaction) = 0.02)) or with WC increase (P(interaction) = 0.01), whereas these increases were small and nonsignificant in Australian children. CONCLUSION These findings suggest that SEAsian children living in Australia are at higher risk of increasing SBP than their Australian counterparts when they become overweight or obese.

Health status and coping strategies among older parent-carers of adults with intellectual disabilities in an Australian sample.

BACKGROUND Older parent-carers in Australia are the subject of increasing policy and practice attention due to concerns about their ongoing ability to care in the light of their own ageing and the ageing of their adult son or daughter. This paper examines health status and the coping strategies of a group of older Australian parents caring for an adult son or daughter with intellectual disabilities. METHOD Health status using the SF-12 (Ware, Snow, Kosinski, & Gandek, 1993), caring stress using the CADI (Nolan, Grant, & Keady, 1998), and coping strategies using the CAMI (Nolan et al., 1998) were assessed in 64 older parent-carers of adults with intellectual disabilities. RESULTS The self-reported health status of this sample of older parent-carers did not differ significantly from Australian population norms, with one exception. That is, the younger parent-carers in the sample (55-64 years) reported significantly poorer mental health. Better health was associated with having a partner, a larger and close support network of family, friends and neighbours, and a lower care-load. Overall, the study participants identified both satisfaction as well as stress associated with caring, a finding that runs counter to the common perception that being a carer is overwhelmingly burdensome. Common sources of stress were feeling helpless or not in control, and poor professional support. Analysis of older parent-carers coping strategies suggests that self-reliance, whether by choice or necessity, was the norm. CONCLUSIONS The health status of older parent-carers may present less cause for concern than anecdotal reports suggest. That said, the strong self-reliance particularly of the older carers presents a challenge to service providers seeking to engage those whose situation appears to warrant support from the service system.

Culture and sun exposure in immigrant East Asian women living in Australia

In this qualitative study, researchers examined cultural and attitudinal factors that might be related to sun-exposure behaviors among East Asian women living in Australia. Researchers asked Chinese (n = 20) and Korean (n = 16) immigrant women who participated in a larger cross-sectional quantitative study of vitamin D blood levels to volunteer to participate in an in-depth interview in 2010. These women reported a number of cultural factors related to their attitudes and behaviors with regard to sun exposure. They expressed preference for fair skin, a tradition of covering skin when outdoors, and no sunbathing culture. They believed that fair skin was more beautiful than tanned skin. They reported that beauty was the reason for active avoidance of sunlight exposure. Although they reported knowledge of the need for sun avoidance due to skin cancer risk, few reported knowledge about the benefits of sun exposure for adequate vitamin D levels. These findings may provide some reasons for vitamin D deficiency previously reported in these populations. Thus, researchers recommend that these attitudes of excessive sun protection and limiting sun exposure be further investigated as they may have implications for planning and delivery of health promotion programs to this growing population of immigrants in Australia.

Implications for tertiary education: managerial competencies required of beginning practitioners in the health service sector

Five hundred and three experienced practitioners involved in management from four professional fields (medical radiation science, occupational therapy, speech pathology and physiotherapy) representing a range of health care settings participated in a survey. The survey examined the importance attached to managerial competencies for the beginning practitioner. The most important grouping related to management of future planning. Underlying competencies included decision making regarding time management and communication with other staff. The second most important grouping of managerial competencies related to organisational practices. These competencies included strategic and organisation-wide management processes associated with change, vision, organisational awareness and decision making. The third grouping of managerial competencies related to knowledge regarding legislation and in particular compliance with occupational health and safety regulations. Other competencies were seen as less important for the beginning practitioner. The implications of these findings are discussed in relation to health science curriculum development in higher education.

What Managerial Skills Do Newly Graduated Occupational Therapists Need? A View from Their Managers

Ninety-four occupational therapy managers, representing a response rate of 59%, completed a questionnaire examining perceptions of the relative importance of various managerial skills for new graduates in occupational therapy. The set of skills perceived to be the most important related to the management of future planning and skills; within this set, time management, prioritising work tasks and planning goals for a work team were emphasised. The second most important set of skills related to organisational practices, such as being an advocate for the department/unit, and the third most important set of skills related to team leadership skills. Just over half of the occupational therapy managers who responded (55%) agreed that managerial skills should be taught at undergraduate level. The implications of these findings for curriculum development in undergraduate occupational therapy courses are discussed.

The Home and Caregiving: Rethinking Space and its Meaning

Occupational therapists are routinely engaged in the homes of their clients with disabilities, providing consultation on the use and modification of space to improve functional independence. The meaning of home space is currently underexplored. This study describes the meaning and use of home space for mothers who are primary caregivers for a child or adolescent with disabilities and high support needs. This article reports data from two empirical studies of mothers of children and adolescents with disabilities. In-depth interviews were conducted with 80 mothers across the two studies. Interview transcripts were analyzed with a grounded theory approach. Access around the home for a family member with disabilities allowed mothers to combine caring with other home management activities. However, preventing access or excluding the family member with a disability from some areas of the home enabled the mothers to resist the medicalization of their homes and create a personal space for themselves. Full access to the home for the child with disabilities was rarely a desirable outcome. Decisions about the home and how it should be modified to improve function become more complex when the needs of family members are taken into account. Meaning ascribed to space within the home is integral to how the space is used and whether a family member with a disability is included or excluded from the space. For occupational therapists, the meaning that clients and their families ascribe to various spaces within the home is as important as the use of space.

Worry in Older Community-Residing Adults.

With rising longevity, increasing numbers of older people are experiencing changes in their everyday family and social life, changes in their financial status, and a greater number of chronic conditions affecting their health. We took the opportunity to explore these relationships with worry in a group of volunteer community-living elderly (n = 310). Findings showed that that those people under 75 years of age had a higher risk of worrying (OR = 1.8, 95% CI = 1.0–3.1) compared to the older age groups. Women worried more than men and an important finding was that those with chronic health conditions such as arthritis of the hip and knee were more prone to worry than those who were healthy or had acute conditions (OR = 3.5, 95% CI = 1.4–8.9). This latter finding suggests the importance placed on the role of the hip and knee in maintaining functional capacity to perform life skills.

Parental obesity as a predictor of childhood overweight/obesity in Australian migrant children

SUMMARY Obesity levels are increasing disproportionately in immigrant children worldwide. We investigated predictors of immigrant childrens obesity status in a well-documented 3-year follow-up study of children at 9 years (n = 1232) and 12 years (n = 628) of age living in inner city areas of Sydney (Australia). The major immigrant groups in this sample were from Europe, the Middle East and SE Asia. Having an obese parent and having either parent or child not being born in Australia and not playing organised sport were predictors of childhood obesity. If either parent was obese compared to non-obese, then the odds ratio for a 9-year-old child of being obese compared to normal weight was 4.9 (95% CI: 3.0-8.0); for 12-year olds the odds ratio was 8.0 (95% CI: 3.6-18). For the survey of 9-years old, a parent born outside Australia or if the child himself was born outside Australia was associated with an almost twofold chance of being obese (OR = 1.8, 95% CI: 1.1-3.0), and not participating in organised sports was significantly associated with childhood obesity. Nine-year olds who did not participate in organised sports outside of school hours were almost twice as likely to be obese (OR = 1.9, 95% CI: 1.2-2.9). When stratified by ethnicity, participation in sports was not related to lower obesity status in children of SE Asian origin. One reason for this could be because SE Asian had very limited participation in sports compared to their counterparts. Accordingly, we believe that health promotion messages to avoid obesity need to be targeted ethnic-specifically.:

The Importance of Managerial Competencies for New Graduates in Speech Pathology

The type and extent of management skills required by new graduate speech pathologists in the health care context is currently unknown. This study surveyed 47 experienced speech pathologists to investigate their perceptions of the relative importance of various management skills for new graduate speech pathologists. New graduate speech pathologists were defined as clinicians who had less than 2 years employment experience. The set of skills perceived to be most important related to management of future planning, and skills within this set included time management, prioritising work tasks, and planning goals for the work team. The second most important set of skills related to organisational practices such as being an advocate for the department/unit, and the third most important set of skills related to legislative knowledge. The implications of the results for undergraduate speech pathology education programs, professional associations, senior speech pathology managers, and public and private employers are discussed.