scholarly journals Does improved interpreter uptake reduce self-discharge rates in hospitalised patients? A successful hospital intervention explained

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0257825
Author(s):  
Elise O’Connor ◽  
Vicki Kerrigan ◽  
Robyn Aitken ◽  
Craig Castillon ◽  
Vincent Mithen ◽  
...  
Keyword(s):  
Online Survey ◽  
Aboriginal People ◽  
Sudden Increase ◽  
Inverse Association ◽  
Northern Australia ◽  
Intervention Period ◽  
Interpreter Use ◽  
Discharge Rates ◽  
Hospitalised Patients ◽  
Study Intervention

Background Aboriginal language interpreters are under-utilised in healthcare in northern Australia. Self-discharge from hospital is an adverse outcome occurring at high rates among Aboriginal people, with poor communication thought to be a contributor. We previously reported increased Aboriginal interpreter uptake and decreased rates of self-discharge during implementation of a 12-month hospital-based intervention. Interrupted time-series analysis showed sudden increase and up-trending improvement in interpreter use, and a corresponding decrease in self-discharge rates, during a 12-month intervention period (April 2018—March 2019) compared with a 24-month baseline period (April 2016 –March 2018). This paper aims to investigate reasons for these outcomes and explore a potential causal association between study activities and outcomes. Methods The study was implemented at the tertiary referral hospital in northern Australia. We used the Template for Intervention Description and Replication (TIDieR) as a framework to describe intervention components according to what, how, where, when, how much, tailoring, modifications and reach. Components of the study intervention were: employment of an Aboriginal Interpreter Coordinator, ‘Working with Interpreters’ training for healthcare providers, and championing of interpreter use by doctors. We evaluated the relative importance of intervention components according to TIDieR descriptors in relation to outcomes. Activities independent of the study that may have affected study findings were reviewed. The relationship between proportion of hospital separations among Aboriginal people ending in self-discharge and numbers of Aboriginal interpreter bookings made during April 2016-March 2019 was tested using linear regression. ‘Working with Interpreters’ training sessions were undertaken at a regional hospital as well as the tertiary hospital. Training evaluation comprised an anonymous online survey before the training, immediately after and then at six to eight months. Survey data from the sites were pooled for analysis. Results Employment of the Aboriginal Interpreter Coordinator was deemed the most important component of the intervention, based on reach compared to the other components, and timing of the changes in outcomes in relation to the employment period of the coordinator. There was an inverse association between interpreter bookings and self-discharge rate among Aboriginal inpatients throughout the baseline and intervention period (p = 0.02). This association, the timing of changes and assessment of intercurrent activities at the hospital indicated that the study intervention was likely to be casually related to the measured outcomes. Conclusions Communication in healthcare can be improved through targeted strategies, with associated improvements in patient outcomes. Health services with high interpreter needs would benefit from employing an interpreter coordinator.

scholarly journals A complex intervention to improve intercultural communication and Aboriginal patient outcomes: which components worked?

2020 ◽  
Author(s):  
Anna P Ralph ◽  
Vicki Kerrigan ◽  
Craig Castillon ◽  
Vincent Mithen ◽  
Elise O'Connor ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Aboriginal People ◽  
Discharge Rate ◽  
Baseline Period ◽  
Sudden Increase ◽  
Inverse Association ◽  
Full Time ◽  
Intervention Period ◽  
Interrupted Time Series Analysis ◽  
Interpreter Use

Abstract Background Aboriginal language interpreters are under-utilised in healthcare in northern Australia. Self-discharge from hospital is an adverse outcome occurring at high rates among Aboriginal people, with poor communication thought to be a contributor. We previously reported increased Aboriginal interpreter uptake and decreased rates of self-discharge during implementation of a 12-month hospital-based intervention. Interrupted time-series analysis showed sudden increase and up-trending improvement in interpreter use, and a corresponding decrease in self-discharge rates, during a 12-month intervention period (April 2018 - March 2019) compared with a 24-month baseline period (April 2016 – March 2018). This paper aims to explore reasons for these outcomes, and further explore the likelihood of a causal association between study activities and outcomes. Methods We used the ‘Template for Intervention Description and Replication’ (TIDieR) as a framework to describe intervention components and evaluate their relative importance. Information on intercurrent activities that may have contaminated study findings was reviewed. The relationship between proportion of hospital separations among Aboriginal people ending in self-discharge and numbers of Aboriginal interpreter bookings made during April 2016-March 2019 was tested using linear regression. Results One full-time Aboriginal Interpreter Coordinator was employed for the intervention period who identified language needs, promoted interpreter use and mentored interpreters. The intervention period start date corresponded with commencement of this role. Three ‘Working with Interpreter’ training sessions were held during the intervention period reaching 83 clinicians, and three medical officers volunteered as champions of interpreter use in hospital practice. Employment of the Aboriginal Interpreter Coordinator was deemed the most important component of the intervention, based on reach compared to the other components and timing of the changes in outcomes. There was an inverse association between interpreter bookings and self-discharge rate among Aboriginal inpatients (p = 0.02). This association, the timing of changes and assessment of intercurrent activities at the hospital indicated that the study intervention was likely to be casually related to the measured outcomes. Conclusions Communication in healthcare can be improved through targeted strategies, with associated improvements in patient outcomes. Health services with high interpreter needs would benefit from employing an interpreter coordinator.

scholarly journals A Complex Intervention to Improve Intercultural Communication and Aboriginal Patient Outcomes: Which Components Worked?

2020 ◽  
Author(s):  
Anna P Ralph ◽  
Vicki Kerrigan ◽  
Craig Castillon ◽  
Vincent Mithen ◽  
Elise O'Connor ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Aboriginal People ◽  
Discharge Rate ◽  
Baseline Period ◽  
Sudden Increase ◽  
Inverse Association ◽  
Full Time ◽  
Intervention Period ◽  
Interrupted Time Series Analysis ◽  
Interpreter Use

Abstract BackgroundAboriginal language interpreters are under-utilised in healthcare in northern Australia. Self-discharge from hospital is an adverse outcome occurring at high rates among Aboriginal people, with poor communication thought to be a contributor. We previously reported increased Aboriginal interpreter uptake and decreased rates of self-discharge during implementation of a 12-month hospital-based intervention. Interrupted time-series analysis showed sudden increase and up-trending improvement in interpreter use, and a corresponding decrease in self-discharge rates, during a 12-month intervention period (April 2018 - March 2019) compared with a 24-month baseline period (April 2016 – March 2018). This paper aims to explore reasons for these outcomes, and further explore the likelihood of a causal association between study activities and outcomes. MethodsWe used the ‘Template for Intervention Description and Replication’ (TIDieR) as a framework to describe intervention components and evaluate their relative importance. Information on intercurrent activities that may have contaminated study findings was reviewed. The relationship between proportion of hospital separations among Aboriginal people ending in self-discharge and numbers of Aboriginal interpreter bookings made during April 2016-March 2019 was tested using linear regression. ResultsOne full-time Aboriginal Interpreter Coordinator was employed for the intervention period who identified language needs, promoted interpreter use and mentored interpreters. The intervention period start date corresponded with commencement of this role. Three ‘Working with Interpreter’ training sessions were held during the intervention period reaching 83 clinicians, and three medical officers volunteered as champions of interpreter use in hospital practice. Employment of the Aboriginal Interpreter Coordinator was deemed the most important component of the intervention, based on reach compared to the other components and timing of the changes in outcomes. There was an inverse association between interpreter bookings and self-discharge rate among Aboriginal inpatients (p=0.02). This association, the timing of changes and assessment of intercurrent activities at the hospital indicated that the study intervention was likely to be casually related to the measured outcomes. ConclusionsCommunication in healthcare can be improved through targeted strategies, with associated improvements in patient outcomes. Health services with high interpreter needs would benefit from employing an interpreter coordinator.

scholarly journals Binge Drinking and Obesity-Related Eating: The Moderating Roles of the Eating Broadcast Viewing Experience among Korean Adults

2021 ◽  
Vol 18 (15) ◽  
pp. 8066
Author(s):  
Jiye Kim ◽  
Saegyeol Choi ◽  
Hyekyeong Kim ◽  
Soontae An
Keyword(s):  
Binge Drinking ◽  
Online Survey ◽  
Eating Behaviors ◽  
Inverse Association ◽  
Cross Sectional ◽  
Korean Adults ◽  
External Eating ◽  
Drinking Frequency ◽  
The Relationship ◽  
Viewing Experience

Recently, there has been a notable rise in binge drinking and in the popularity of eating broadcasts via TV and online platforms, especially in Korea. This study analyzed the moderating effect of the eating broadcast viewing experience on the relationship between binge drinking and obesity-related eating behaviors. Cross-sectional self-reported online survey data were collected from 1125 Korean adults. Moderation models for restrained, emotional, and external eating behaviors were tested using moderation analyses with Hayes’s PROCESS version 3.5 compatible with SPSS. As a result, the eating broadcast viewing experience moderated the relationship between binge drinking frequency and external eating (Fchange = 2.686, p = 0.045). More frequent binge drinking was associated with a higher level of external eating in participants who only watched online eating broadcasts, especially among women. Participants in their twenties showed the same above association; additionally, those who only watched TV eating broadcasts showed an inverse association, indicating that more frequent binge drinking was associated with a lower level of external eating. Consequently, an eating broadcast viewing experience was one of the environmental factors associated with binge drinking that influences obesity-related eating behaviors.

Kava : A Challenge to Alcohol?

1987 ◽  
Vol 15 (2) ◽  
pp. 41-53
Author(s):  
J.E. Cawte
Keyword(s):  
Pacific Islands ◽  
Aboriginal People ◽  
South Pacific ◽  
Pacific Region ◽  
Northern Australia ◽  
The South ◽  
Aboriginal Communities ◽  
North East ◽  
The Pacific ◽  
Arnhem Land

Kava has been introduced into Aboriginal communities in Northern Australia. Persons from Yirrkala in North East Arnhem Land visiting the South Pacific region on study tours have been impressed by their welcome in Kava bowl ceremonies, and some of them hoped that the Aborigines might use Kava instead of alcohol.In 1983 many Aboriginal people in Arnhem Land used Kava, and much more was used in 1984. By 1985 it became a social epidemic or ‘craze’ in many communities. Rings of people of both sexes and of all ages often sit together under trees around Kava bowls for many hours. They may drink up to a hundred times the amount normally drunk in the Pacific Islands by the same number of people in the same time.

Sensory Representation of Temperature in Mosquito Warm and Cold Cells

2005 ◽  
Vol 94 (1) ◽  
pp. 176-185 ◽  
Author(s):  
Ewald Gingl ◽  
Armin Hinterwirth ◽  
Harald Tichy
Keyword(s):  
Radiation Power ◽  
Discharge Rate ◽  
Radiant Heat ◽  
Cell Types ◽  
Sudden Increase ◽  
Change Analysis ◽  
Temperature Changes ◽  
Discharge Rates ◽  
Air Stream ◽  
Instantaneous Values

A pair of antagonistic thermoreceptive cells is associated with each of two peg-in-pit sensilla located on the antennal tip of Aedes aegypti. One, the warm cell, responds to rapid warming with a sudden increase in the rate of discharge. The other, a cold cell, responds to rapid cooling with a sudden increase in the discharge rate. When temperature changes are provided by oscillating changes in the convective heat contained in the stimulating air stream, the oscillating discharge rates of both cell types are in advance of the oscillations in temperature and slightly behind the oscillations in the rate of temperature change. Analysis of these phase relationships shows that both cell types respond not only to the actual temperature at particular instants in time (instantaneous temperature) but also to the rate with which temperature changes. Individual responses are therefore ambiguous and signal tendencies rather than precise instantaneous values. When the temperature oscillations are delivered by changes in radiation power, however, the oscillating discharge rates of the warm and cold cells are in step with the oscillations in temperature. Here, individual responses signal instantaneous values of temperature rather than tendencies. The power of radiant heat required to modulate the discharge rates is relatively high, suggesting that infrared radiation is not a significant cue in distant host location.

scholarly journals An Urban Frontier: Respatializing Government in Remote Northern Australia

2015 ◽  
Vol 30 (1) ◽  
pp. 139-168 ◽  
Author(s):  
Daniel T. Fisher
Keyword(s):  
Urban Space ◽  
Aboriginal People ◽  
Ethnographic Research ◽  
Northern Australia ◽  
Australian Government ◽  
State Of Emergency ◽  
Aboriginal Australians ◽  
Aboriginal Society ◽  
Australian City

This essay draws on ethnographic research with Aboriginal Australians living in the parks and bush spaces of a Northern Australian city to analyze some new governmental measures by which remoteness comes to irrupt within urban space and to adhere to particular categories of people who live in and move through this space. To address this question in contemporary Northern Australia is also to address the changing character of the Australian government of Aboriginal people as it moves away from issues of redress and justice toward a state of emergency ostensibly built on settler Australian compassion and humanitarian concern. It also means engaging with the mediatization of politics and its relation to the broader, discursive shaping of such spatial categories as remote and urban. I suggest that remoteness forms part of the armory of recent political efforts to reshape Aboriginal policy in Northern Australia. These efforts leverage remoteness to diagnose the ills of contemporary Aboriginal society, while producing remoteness itself as a constitutive feature of urban space.

Rapid appraisal links feral buffalo with kunkod (Melaleuca spp.) decline in freshwater billabongs of tropical northern Australia

2017 ◽  
Vol 68 (9) ◽  
pp. 1642 ◽  
Author(s):  
E. J. Ens ◽  
S. Bentley-Toon ◽  
F. Campion ◽  
S. Campion ◽  
J. Kelly ◽  
...  
Keyword(s):  
Aboriginal People ◽  
High Water ◽  
Freshwater Wetlands ◽  
Northern Australia ◽  
Community Based ◽  
Collaborative Community ◽  
Rapid Appraisal ◽  
The Tropics ◽  
Reduced Water ◽  
Ongoing Monitoring

Freshwater wetlands have great ecological, social, cultural and economic importance and are considered some of the most threatened ecosystems globally, especially in the tropics. In the tropics of northern Australia, much land is owned by Aboriginal people, thus requiring community-based approaches to monitoring and decision making. Herein we present a collaborative community-based rapid appraisal of an observed decline in a culturally and ecologically important tree genus of the freshwater wetlands in northern Australia, locally known as kunkod (Melaleuca spp., Myrtaceae) by Bininj (local Aboriginal people). We conducted collaborative research with the local Aboriginal Djelk Rangers incorporating local and scientific knowledge and preferred research methods. The decline in kunkod was more common in the water zone than in the mud and dry zones of freshwater billabongs in the Djelk Indigenous Protected Area. Kunkod decline and poor regeneration were significantly correlated with high water electrical conductivity, turbidity and ammonium. Feral buffalo activity was also positively correlated with these parameters, suggesting an indirect effect of buffalo on kunkod population health (large and small trees) through reduced water quality rather than direct rubbing on the trees, as was initially expected. Ongoing monitoring will allow assessment of potential recovery of kunkod following planned feral buffalo control.

Associations between Suicide Behaviors and Religiosity in Young Adults

2021 ◽  
Vol 35 (4) ◽  
Author(s):  
Shannon Gwin ◽  
Paul Branscum ◽  
E. Laurette Taylor ◽  
Marshall Cheney ◽  
Sarah B. Maness ◽  
...  
Keyword(s):  
Mental Health ◽  
Young Adults ◽  
Online Survey ◽  
Suicide Ideation ◽  
Health Interventions ◽  
Inverse Association ◽  
Parental Relationships ◽  
Mental Health Interventions ◽  
Southwestern State ◽  
Suicide Behaviors

The purpose of this study was to examine associations between suicide ideation, parental relation- ships, and religiosity among young adults. An online survey was administered to students (n=775) from colleges and universities in a southwestern state measuring suicide ideation, protective assets of parental relationships, and religiosity beliefs. Odds ratios analysis revealed a significant inverse association between religiosity and suicide ideation. Overall, higher rates religiosity appears to be associated with lower bouts of suicide ideation in the last 12 months. Addition of religious/spirituality-oriented tools may be important to incorporate in mental health interventions for those young adults that report having greater religiosity.

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