Development and feasibility testing of an education program to improve knowledge and self-care among Aboriginal and Torres Strait Islander patients with heart failure

Background/Aim There is a 70% higher age-adjusted incidence of heart failure (HF) amongst Aboriginal and Torres Strait Islander people, three times more hospitalisations and twice as many deaths than non-Aboriginal people. There is a need to develop holistic yet individualised approaches in accord with the values of Aboriginal community healthcare to support patient education and self-care. The aim of this study was to re-design an existing HF educational resource (Fluid Watchers-Pacific Rim©) to be culturally safe for Aboriginal and Torres Strait Islander peoples, working in collaboration with the local community, and to conduct feasibility testing. Methods This study was conducted in two phases and utilised a mixed methods approach (qualitative and quantitative). Phase 1 of this study used action research methods to develop a culturally safe electronic resource to be provided to Aboriginal HF patients via a tablet computer. A HF expert panel adapted the existing resource to ensure it was evidence-based and contained appropriate language and images that reflects Aboriginal culture. A stakeholder group (which included Aboriginal workers and HF patients, as well as researchers and clinicians) then reviewed the resources and changes were made accordingly. In Phase 2, the new resource was tested on a sample of Aboriginal HF patients to assess feasibility and acceptability. Patient knowledge, satisfaction and self-care behaviours were measured using a before and after design with validated questionnaires. As this was a pilot test to determine feasibility, no statistical comparisons were made. Results - Phase 1: Throughout the process of resource development, two main themes emerged from the stakeholder consultation. These were the importance of identity, meaning that it was important to ensure that the resource accurately reflected the local community, with the appropriate clothing, skin tone and voice. The resource was adapted to reflect this and of the local community voiced the recordings for the resource. The other theme was comprehension; images were important and all text was converted to the first person and used plain language. - Phase 2: Five Aboriginal participants, mean age 61.6 ± 10.0 years, with NYHA Class III and IV heart failure were enrolled. Participants reported a high level of satisfaction with the resource (83.0%). HF knowledge (percentage of correct responses) increased from 48.0 ± 6.7% to 58.0 ± 9.7%, a 20.8% increase and results of the self-care index indicated that the biggest change was in patient confidence for self-care with a 95% increase in confidence score (46.7 ± 16.0 to 91.1 ± 11.5). Changes in management and maintenance scores varied between9275 patients. Conclusion By working in collaboration with HF experts, Aboriginal researchers and patients, a culturally safe HF resource has been developed for Aboriginal and Torres Strait Islander patients. Engaging Aboriginal researchers, capacity-building, and being responsive to local systems and structures enabled this pilot study to be successfully completed with the Aboriginal community and positive participant feedback demonstrated that the methodology used in this study was appropriate and acceptable; participants were able to engage with willingness and confidence.

Principles to guide sustainable implementation of extended-scope-of-practice physiotherapy workforce redesign initiatives in Australia: Stakeholder perspectives, barriers, supports, and incentives

Sustainable implementation of new workforce redesign initiatives requires strategies that minimize barriers and optimize supports. Such strategies could be provided by a set of guiding principles. A broad understanding of the concerns of all the key stakeholder groups is required before effective strategies and initiatives are developed. Many new workforce redesign initiatives are not underpinned by prior planning, and this threatens their uptake and sustainability. This study reports on a cross-sectional qualitative study that sought the perspectives of representatives of key stakeholders in a new workforce redesign initiative (extended-scope-of-practice physiotherapy) in one Australian tertiary hospital. The key stakeholder groups were those that had been involved in some way in the development, management, training, funding, and/or delivery of the initiative. Data were collected using semistructured questions, answered individually by interview or in writing. Responses were themed collaboratively, using descriptive analysis. Key identified themes comprised: the importance of service marketing; proactively addressing barriers; using readily understood nomenclature; demonstrating service quality and safety, monitoring adverse events, measuring health and cost outcomes; legislative issues; registration; promoting viable career pathways; developing, accrediting, and delivering a curriculum supporting physiotherapists to work outside of the usual scope; and progression from "a good idea" to established service. Health care facilities planning to implement new workforce initiatives that extend scope of usual practice should consider these issues before instigating workforce/model of care changes. © 2014 Morris et al.

Establishment and management of salt-tolerant amenity grasses to reduce urban salinity effect

This project built upon the successful outcomes of a previous project (TU02005) by adding to the database of salt tolerance among warm season turfgrass cultivars, through further hydroponic screening trials. Hydroponic screening trials focussed on new cultivars or cultivars that were not possible to cover in the time available under TU02005, including: 11 new cultivars of Paspalum vaginatum; 13 cultivars of Cynodon dactylon; six cultivars of Stenotaphrum secundatum; one accession of Cynodon transvaalensis; 12 Cynodon dactylon x transvaalensis hybrids; two cultivars of Sporobolus virginicus; five cultivars of Zoysia japonica; one cultivar of Z. macrantha, one common form of Z. tenuifolia and one Z. japonica x tenuifolia hybrid. The relative salinity tolerance of different turfgrasses is quantified in terms of their growth response to increasing levels of salinity, often defined by the salt level that equates to a 50% reduction in shoot yield, or alternatively the threshold salinity. The most salt tolerant species in these trials were Sporobolus virginicus and Paspalum vaginatum, consistent with the findings from TU02005 (Loch, Poulter et al. 2006). Cynodon dactylon showed the largest range in threshold values with some cultivars highly sensitive to salt, while others were tolerant to levels approaching that of the more halophytic grasses. Coupled with the observational and anecdotal evidence of high drought tolerance, this species and other intermediately tolerant species provide options for site specific situations in which soil salinity is coupled with additional challenges such as shade and high traffic conditions. By recognising the fact that a salt tolerant grass is not the complete solution to salinity problems, this project has been able to further investigate sustainable long-term establishment and management practices that maximise the ability of the selected grass to survive and grow under a particular set of salinity and usage parameters. Salt-tolerant turf grasses with potential for special use situations were trialled under field conditions at three sites within the Gold Coast City Council, while three sites, established under TU02005 within the Redland City Council boundaries were monitored for continued grass survival. Several randomised block experiments within Gold Coast City were established to compare the health and longevity of seashore paspalum (Paspalum vaginatum), Manila grass (Zoysia matrella), as well as the more tolerant cultivars of other species like buffalo grass (Stenotaphrum secundatum) and green couch (Cynodon dactylon). Whilst scientific results were difficult to achieve in the field situation, where conditions cannot be controlled, these trials provided valuable observational evidence of the likely survival of these species. Alternatives to laying full sod such as sprigging were investigated, and were found to be more appropriate for areas of low traffic as the establishment time is greater. Trials under controlled and protected conditions successfully achieved a full cover of Paspalum vaginatum from sprigs in a 10 week time frame. Salt affected sites are often associated with poor soil structure. Part of the research investigated techniques for the alleviation of soil compaction frequently found on saline sites. Various methods of soil de-compaction were investigated on highly compacted heavy clay soil in Redlands City. It was found that the heavy duplex soil of marine clay sediments required the most aggressive of treatments in order to achieve limited short-term effects. Interestingly, a well constructed sports field showed a far greater and longer term response to de-compaction operations, highlighting the importance of appropriate construction in the successful establishment and management of turfgrasses on salt affected sites. Fertiliser trials in this project determined plant demand for nitrogen (N) to species level. This work produced data that can be used as a guide when fertilising, in order to produce optimal growth and quality in the major turf grass species used in public parkland. An experiment commenced during TU02005 and monitored further in this project, investigated six representative warm-season turfgrasses to determine the optimum maintenance requirements for fertiliser N in south-east Queensland. In doing so, we recognised that optimum level is also related to use and intensity of use, with high profile well-used parks requiring higher maintenance N than low profile parks where maintaining botanical composition at a lower level of turf quality might be acceptable. Kikuyu (Pennisetum clandestinum) seemed to require the greatest N input (300-400 kg N/ha/year), followed by the green couch (Cynodon dactylon) cultivars ‘Wintergreen’ and ‘FLoraTeX’ requiring approximately 300 kg N/ha/year for optimal condition and growth. ‘Sir Walter’ (Stenotaphrum secundatum) and ‘Sea Isle 1’ (Paspalum vaginatum) had a moderate requirement of approximately 200 kg/ha/year. ‘Aussiblue’ (Digitaria didactyla)maintained optimal growth and quality at 100-200 kg N/ha/year. A set of guidelines has been prepared to provide various options from the construction and establishment of new grounds, through to the remediation of existing parklands by supporting the growth of endemic grasses. They describe a best management process through which salt affected sites should be assessed, remediated and managed. These guidelines, or Best Management Practices, will be readily available to councils. Previously, some high salinity sites have been turfed several times over a number of years (and Council budgets) for a 100% failure record. By eliminating this budgetary waste through targeted workable solutions, local authorities will be more amenable to investing appropriate amounts into these areas. In some cases, this will lead to cost savings as well as resulting in better quality turf. In all cases, however, improved turf quality will be of benefit to ratepayers, directly through increased local use of open space in parks and sportsfields and indirectly by attracting tourists and other visitors to the region bringing associated economic benefits. At the same time, environmental degradation and erosion of soil in bare areas will be greatly reduced.

Making More from Sheep Phase II : MMfS State Coordination – Queensland

Making More from Sheep (MMfS) is a majority market extension program funded by Meat & Livestock Australia (MLA) and Australian Wool Innovation (AWI). Phase II of MMfS commenced in Queensland with a business planning process in October 2010 and delivery from November 2010 until November 2013. Mr Tony Hamilton of the Department of Agriculture, Fisheries and Forestry (DAFF) was initially the State Coordinator with responsibility for planning, project implementation, monitoring and evaluation. He was replaced by Ms Nicole Sallur from DAFF towards the end of the project. Delivery involving partner organisations provided best practice management information and tools to sheep producers with target Key Performance Indicators (KPI’s) exceeded across all three tiers of engagement category. 31 events were delivered to 551 participants. Satisfaction and value scores averaged across all events measured 8.7 and 8.2 respectively. Operational recommendations have been included in the report.

Banana Plant Protection Program

Developing a National Banana Plant Protection Program four key strategic areas have been identified which each address a number of key strategic objectives. Taken together they address the key strategic objectives as outlined in the strategic plan. The four key strategic areas of the Plant Protection Program are: 1. Resistant Varieties and Consumer Choice; 2. Safeguarding Production and Markets; 3. Sustainable Production Systems; 4. Building Science and Communication.

National Rhizobium Program - Managing rhizobia to maximise Nitrogen fixation

Inoculation of legumes with rhizobia is fundamental to sustainable productivity of Australian agriculture. The National Rhizobium Program has specific aims of sustaining and increasing Nitrogen fixation by legumes in Australian agriculture.

Regenerative sustainability for the built environment – from vision to reality: An introductory chapter

Regenerative sustainability is emerging as an alternative discourse around the transition from a ‘mechanistic’ to an ‘ecological’ or living systems worldview. This view helps us to re-conceptualize relationships among humans’ technological, ecological, economic, social and political systems. Through exploration of ‘net positive’ or ‘regenerative’ development lenses and the traditional sustainability literature, the conceptualization and approaches to achieve sustainable development and ecological modernization are expanded to articulate and to explore the evolving sustainability discourse, ‘regenerative sustainability’. This Special Volume of Journal of Cleaner Production (SV) is focused upon various dimensions of regenerative sustainability (e.g. regenerative design, regenerative development, and positive development) applied to the urban built environment at scales, which range from individual buildings, neighborhoods, and urban developments to integrated regional sustainable development. The main focus is on how these approaches and developments are evolving, how they can help us to prevent or adapt to climate change and how these approaches are likely to evolve in the next two to three decades. These approaches are addressed in four themes: (1) reviewing the theoretical development of the discourse of regenerative sustainability, its emerging principles and practices, (2) explaining how it can be measured and monitored, (3) providing encouraging practical pathways and examples of its implementation in multiple cultural and climatic contexts, and (4) mapping obstacles and enablers that must be addressed to help to ensure that more rapid progress is made in implementing the transitions towards an urban built environment that supports genuinely sustainable societies.

Interval Data Classification under Partial Information: A Chance-Constraint Approach

This paper presents a Chance-constraint Programming approach for constructing maximum-margin classifiers which are robust to interval-valued uncertainty in training examples. The methodology ensures that uncertain examples are classified correctly with high probability by employing chance-constraints. The main contribution of the paper is to pose the resultant optimization problem as a Second Order Cone Program by using large deviation inequalities, due to Bernstein. Apart from support and mean of the uncertain examples these Bernstein based relaxations make no further assumptions on the underlying uncertainty. Classifiers built using the proposed approach are less conservative, yield higher margins and hence are expected to generalize better than existing methods. Experimental results on synthetic and real-world datasets show that the proposed classifiers are better equipped to handle interval-valued uncertainty than state-of-the-art.

African mahogany (Khaya senegalensis) plantations in Australia - status, needs and progress

The Australian African mahogany estate comprises over 12,000 ha of industrial plantations, farm-forestry plots and trials, virtually all derived from Africa-sourced wild seed. However, the better trees have given high-value products such as veneers, high-grade boards and award-winning furniture. Collaborative conservation and improvement by the Northern Territory (NT) and Queensland governments since 2000 realised seed orchards, hedge gardens and genetic tests revealing promising clones and families. Private sector R&D since the mid 2000s includes silvicultural-management and wood studies, participatory testing of government material and establishing over 90 African provenances and many single-tree seedlots in multisite provenance and family trials. Recent, mainly public sector research included a 5-agency project of 2009-12 resulting in advanced propagation technologies and greater knowledge of biology, wood properties and processing. Operational priority in the short term should focus on developing seed production areas and ‘rolling front’ clonal seed orchards. R&D priorities should include: developing and implementing a collaborative improvement strategy based on pooled resources; developing non-destructive evaluation of select-tree wood properties, micropropagation (including field testing of material from this source) to ‘industry ready’ and a select-tree index; optimising seed production in orchards; advancing controlled pollination techniques; and maximising benefits from the progeny, clone and provenance trials. Australia leads the world in improvement and ex situ conservation of African mahogany based on the governments’ 13-year program and more recent industry inputs such that accumulated genetic resources total over 120 provenances and many families from 15 of the 19 African countries of its range. Having built valuable genetic resources, expertise, technologies and knowledge, the species is almost ‘industry ready’. The industry will benefit if it exploits the comparative advantage these assets provide. However the status of much of the diverse germplasm introduced since the mid 2000s is uncertain due to changes in ownership. Further, recent reductions of government investment in forestry R&D will be detrimental unless the industry fills the funding gaps. Expansion and sustainability of the embryonic industry must capitalise on past and current R&D, while initiating and sustaining critical new work through all-stakeholder collaboration.

"Gift Giving" by wild bottle-nose dolphins (tursiops sp.) to humans at a wild dolphin provisioning program, Tangalooma, Australia

Since 1992, wild dolphin provisioning has occurred on a nightly basis at Tangalooma, a resort located on Moreton Island, Australia. Each evening at dusk up to 12 bottlenose dolphins (Tursiops sp.) are provided with fish in a regulated provisioning program. Since July 1998, biologists managing the program have documented 23 occurrences of "gift giving," when several of the provisioned dolphins have offered wild-caught cephalopod or fin fish species to staff members. The characteristics of each of these events are presented, and we explore the relationships between these events and their temporal patterns, and the age and sex of the dolphins involved. We also consider the behavioral explanations for the "gift giving," including prey sharing, play, and teaching behaviors, which have previously been described for cetaceans and other higher mammals. Gift giving may occur either as a discreet behavior (that may be a sequel to one or more other behaviors such as play or food preparation), or as a part of other behaviors, such as play and/or food sharing. It is most likely a manifestation of the particular relationship between the provisioned dolphins and the human participants in the provisioning. Gift giving has become an established but infrequent part of the culture of the provisioned dolphins at Tangalooma. © ISAZ 2012 Printed in the UK.

Experimental and numerical investigation of the behaviour of CFRP strengthened CHS beams subjected to bending

This paper presents the results of an experimental and numerical program to investigate the circular hollow section (CHS) beams, strengthened using Carbon Fibre Reinforced Polymer (CFRP) sheets. The circular hollow shaped steel beams bonded with different CFRP layer orientations were tested under four-point bending. The mid-span deflection, service load and failure load were recorded. The LHL (where L, first inner longitudinal layer, H, second hoop layer and L, third outer longitudinal layer) and LLH (where L, first inner longitudinal layer, L, second longitudinal layer and H, third outer hoop layer) layer oriented strengthened beams perform slightly better than HHL (where H, first inner hoop layer, H, second hoop layer and L, third outer longitudinal layer) layer oriented strengthened beams. The LHL and LLH layer oriented treated beams showed very similar structural behaviour. Numerical analyses were then conducted on the CFRP strengthened steel CHS beams. The validity of the models has been assessed by comparing the failure loads and mid-span deflections. The effects of various parameters such as bond length, section types, tensile modulus of CFRP, adhesive layer thickness and adhesive types have been studied.

Promoting kangaroo as a sustainable option for meat production on the rangelands of Australia

Implications •As kangaroo meat is sourced from native wildlife, conservation of the species is important in developing sustainable meat harvesting. Landholders, conservationists, and commercial meat producers need to work together to achieve this goal. •The production of high quality meat products from field-harvested carcasses can be augmented through a better understanding of the impact that field conditions and carcass handling have on final meat eating quality. •Food safety is also paramount, with measures taken to minimize the impacts of parasitism and microbial contamination. Any breaches of inspection protocols can only serve to undermine consumer confidence and viability of the industry.

Sustainable building envelope design by considering energy cost and occupant satisfaction

The built environment is a major contributor to the world’s carbon dioxide emissions, with a considerable amount of energy being consumed in buildings due to heating, ventilation and air-conditioning, space illumination, use of electrical appliances, etc., to facilitate various anthropogenic activities. The development of sustainable buildings seeks to ameliorate this situation mainly by reducing energy consumption. Sustainable building design, however, is a complicated process involving a large number of design variables, each with a range of feasible values. There are also multiple, often conflicting, objectives involved such as the life cycle costs and occupant satisfaction. One approach to dealing with this is through the use of optimization models. In this paper, a new multi-objective optimization model is developed for sustainable building design by considering the design objectives of cost and energy consumption minimization and occupant comfort level maximization. In a case study demonstration, it is shown that the model can derive a set of suitable design solutions in terms of life cycle cost, energy consumption and indoor environmental quality so as to help the client and design team gain a better understanding of the design space and trade-off patterns between different design objectives. The model can very useful in the conceptual design stages to determine appropriate operational settings to achieve the optimal building performance in terms of minimizing energy consumption and maximizing occupant comfort level.

Strategies to limit the impact of nematode pressure on sugarcane productivity in the Isis

Two trials were done in this project. One was a continuation of work started under a previous GRDC/SRDC-funded activity, 'Strategies to improve the integration of legumes into cane based farming systems'. This trial aimed to assess the impact of trash and tillage management options and nematicide application on nematodes and crop performance. Methods and results are contained in the following publication: Halpin NV, Stirling GR, Rehbein WE, Quinn B, Jakins A, Ginns SP. The impact of trash and tillage management options and nematicide application on crop performance and plant-parasitic nematode populations in a sugarcane/peanut farming system. Proc. Aust. Soc. Sugar Cane Technol. 37, 192-203. Nematicide application in the plant crop significantly reduced total numbers of plant parasitic nematodes (PPN) but there was no impact on yield. Application of nematicide to the ratoon crop significantly reduced sugar yield. The study confirmed other work demonstrating that implementation of strategies like reduced tillage reduced populations of total PPN, suggesting that the soil was more suppressive to PPN in those treatments. The second trial, a variety trial, demonstrated the limited value of nematicide application in sugarcane farming systems. This study has highlighted that growers shouldn’t view nematicides as a ‘cure all’ for paddocks that have historically had high PPN numbers. Nematicides have high mammalian toxicity, have the potential to contaminate ground water (Kookana et al. 1995) and are costly. The cost of nematicide used in R1 was approx. $320 - $350/ha, adding $3.50/t of cane in a 100 t/ha crop. Also, our study demonstrated that a single nematicide treatment at the application rate registered for sugarcane is not very effective in reducing populations of nematode pests. There appears to be some levels of resistance to nematodes within the current suite of varieties available to the southern canelands. For example the soil in plots that were growing Q183 had 560% more root knot nematodes / 200mL soil compared to plots that grew Q245. The authors see great value in investment into a nematode screening program that could rate varieties into groups of susceptibility to both major sugarcane nematode pests. Such a rating could then be built into a decision support ‘tree’ or tool to better enable producers to select varieties on a paddock by paddock basis.