Reflexivity and aesthetic inquiry : building dialogues between the arts and literacy

Reflection can form the basis for powerful dialogue between the arts and literacy as we seek interpretive and expressive fluency across modes. Through deep, cumulative reflection we make aspects of our world and experiences more perceivable, and open them up for artistic expression and aesthetic inquiry. Such reflections are also the catalysts for self-awareness and identity building. Theories of reflexivity offer a useful lens with which to understand our relationship with the world and the people, texts and things within it. The reflexive process can prompt us to challenge our understandings and change our representations of self and others through text. This paper offers a discussion of reflexivity and the ways in which it can be expressed and performed in discursive and non-discursive ways to develop literacies through and in the arts.

Implementation of sustainable evidence-based practice for the assessment and management of pain in residential aged care facilities

Pain is common in residential aged care facilities (RACFs). In 2005, the Australian Pain Society developed 27 recommendations for good practice in the identification, assessment, and management of pain in these settings. This study aimed to address implementation of the standards and evaluate outcomes. Five facilities in Australia participated in a comprehensive evaluation of RACF pain practice and outcomes. Pre-existing pain management practices were compared with the 27 recommendations, before an evidence-based pain management program was introduced that included training and education for staff and revised in-house pain-management procedures. Post-implementation audits evaluated the program's success. Aged care staff teams also were assessed on their reports of self-efficacy in pain management. The results show that before the implementation program, the RACFs demonstrated full compliance on 6 to 12 standards. By the project's completion, RACFs demonstrated full compliance with 10 to 23 standards and major improvements toward compliance in the remaining standards. After implementation, the staff also reported better understanding of the standards (p < .001) or of facility pain management guidelines (p < .001), increased confidence in therapies for pain management (p < .001), and increased confidence in their training to assess pain (p < .001) and recognize pain in residents with dementia who are nonverbal (p = .003). The results show that improved evidence-based practice in RACFs can be achieved with appropriate training and education. Investing resources in the aged care workforce via this implementation program has shown improvements in staff self-efficacy and practice.

An evidence-based program to improve analgesic practice and pain outcomes in residential aged care facilities

Pain is common in individuals living in residential aged care facilities (RACFs), and a number of obstacles have been identified as recurring barriers to adequate pain management. To address this, the Australian Pain Society developed 27 recommendations for comprehensive good practice in the identification, assessment, and management of pain. This study reviewed preexisting pain management practice at five Australian RACFs and identified changes needed to implement the recommendations and then implemented an evidence-based program that aimed to facilitate better pain management. The program involved staff training and education and revised in-house pain-management procedures. Reviews occurred before and after the program and included the assessment of 282 residents for analgesic use and pain status. Analgesic use improved after the program (P<.001), with a decrease in residents receiving no analgesics (from 15% to 6%) and an increase in residents receiving around-the-clock plus as-needed analgesics (from 24% to 43%). There were improvements in pain relief for residents with scores indicative of pain, with Abbey pain scale (P=.005), Pain Assessment in Advanced Dementia Scale (P=.001), and Non-communicative Patient's Pain Assessment Instrument scale (P<.001) scores all improving. Although physical function declined as expected, Medical Outcomes Study 36-item Short-Form Survey bodily pain scores also showed improvement (P=.001). Better evidence-based practice and outcomes in RACFs can be achieved with appropriate training and education. Investing resources in the aged care workforce using this program improved analgesic practice and pain relief in participating sites. Further attention to the continued targeted pain management training of aged care staff is likely to improve pain-focused care for residents.

Supporting residents’ expression of sexuality : the initial construction of a sexuality assessment tool for residential aged care facilities

Background: Sexuality is a key component of quality of life and well-being and a need to express one’s sexuality continues into old age. Staff and families in residential aged care facilities often find expressions of sexuality by residents, particularly those living with dementia, challenging and facilities often struggle to address individuals’ needs in this area. This paper describes the development of an assessment tool which enables residential aged care facilities to identify how supportive their organisation is of all residents’ expression of their sexuality, and thereby improve where required. Methods: Multi-phase design using qualitative methods and a Delphi technique. Tool items were derived from the literature and verified by qualitative interviews with aged care facility staff, residents and families. The final item pool was confirmed via a reactive Delphi process. Results: A final item pool of sixty-nine items grouped into seven key areas allows facilities to score their compliance with the areas identified as being supportive of older people’s expression of their sexuality in a residential aged care environment. Conclusions: The sexuality assessment tool (SexAT) guides practice to support the normalization of sexuality in aged care homes and assists facilities to identify where enhancements to the environment, policies, procedures and practices, information and education/training are required. The tool also enables facilities to monitor initiatives in these areas over time.

Evaluation of the Australian Performing Arts Market 2014-2018 - Year One Report

The Australia Council awarded the tender of APAMs 2014, 2016 and 2018 to the Brisbane Powerhouse. The Australia Council, in awarding the contract for the presentation of APAM by Brisbane Powerhouse, stipulated that a formal evaluation of the three iterations of APAM and activity in the intervening years be undertaken. Queensland University of Technology, Creative Industries Faculty, under the leadership of Associate Professor Sandra Gattenhof, were contracted to undertake the formal evaluation. This is the first year report on the Brisbane iteration of the Market. This report has drawn from data collected across a range of sources, drawing on the scoping study undertaken by Justin Macdonnell addressing the Market from 1994–2010; the tender document submitted by the Brisbane Powerhouse; in-person interviews with APAM staff, APAM Stakeholders, Vox Pops from delegates in response to individual sessions, producer company/artist case studies and, most significantly, responses from a detailed online survey sent to all delegates. The main body of the report is organised around three key research aims, as outlined in the Brisbane Powerhouse Tender document (2011). These have been articulated as: Evaluation of international market development outcomes through showcasing work to targeted international presenters and agents Evaluation of national market development outcomes through showcasing work to national presenters and producers Evaluation of the exchange ideas, dialogue, skill 
development, partnerships, collaborations and co- productions and networks with local and international peers. The culmination of the data analysis has been articulated through five key recommendations, which may assist the APAM delivery team for the next version, in 2016. In summary, the recommendations are described as: 1. Indigenous focus to remain central to the conception and delivery of APAM 2. Re-framing APAM’s function and its delivery 3. Logistics and communications in a multi-venue approach, including communications and housekeeping, volunteers, catering, re-calibrating the employment of Brisbane Powerhouse protocols and processes for APAM 4. Presentation and promotion for presenters 5. Strategic targeting of Asian producers.

Media Arts should be at the core of the Australian Curriculum

The Final Report of the Review of the Australian Curriculum is seriously flawed. Many aspects of the report have attracted comment – but the recommendation that schools do away with a major, world-leading innovation has not. For the first time, Media Arts, one of the five strands of the Arts curriculum, was to become a compulsory subject for primary school students. This will no longer be the case if the Review’s recommendations are adopted by the government.

Jugglers Arts Space Containers

The design and installation for the Jugglers Arts Space Containers was an invited commission by Jugglers Arts Space for the Containveral Festival at Northshore Hamilton (EDQ). The community festival involved a suite of custom designed and fitted shipping containers for the use by retailers and arts groups alike, focusing upon re-use and low cost design fabrication approaches. Containerval, inspired from shipping container projects such as Sean Goodsell's 'Future Shack' (1985-2001)and Buchan Group's Re:Start Mall, Christchurch (2011), celebrated design testing and exploration of found and recyclable materials to plan and enrich an otherwise severe hardstand area formally attached to Portside docks. The design proposed use of 4 containers, planned to focus on both the interior displays and external in-between spaces, for live performance of Jugglers Arts Space artists. Experimentation of recyclable materials such as onion bags and plastic milk bottles, informed the development of innovative low-cost canopies which sutured the containers together. The Containerval Festival contributed to the now highly successful 'Eat Street Markets' at Hamilton Northshore.

Are empowered women more likely to deliver in facilities? An explorative study using the Nepal Demographic and Health Survey 2011

Development literature has argued that empowering women can effectively increase the utilisation of maternal health care. This study examines this hypothesis in the context of Nepal where only 28% of women delivered in facilities. The two-level random intercept logit models were fitted for data from the Nepal Demographic and Health Surveys 2011. Women‟s empowerment was quantified with a single index constructed from many variables. These variables captured different aspects of women‟s lives and decision-making in their households, and were combined using the principal component analysis method. The results confirmed a positive relationship between women‟s as an inevitable product of the economic development process.

"The red dress or the blue?" How do staff perceive that they support decision making for people with dementia living in residential aged care facilities?

Respect for a person's right to make choices and participate in decision making is generally seen as central to quality of life and well-being. When a person moves into a residential aged care facility (RACF), however, decision making becomes more complicated, particularly if the person has a diagnosis of dementia. Little is known about how staff in RACFs perceive that they support decision making for people with dementia within their everyday practice, and this article seeks to address this knowledge gap. The article reports on the findings of a qualitative study conducted in the states of Victoria and Queensland, Australia with 80 direct care staff members. Findings revealed that the participants utilized a number of strategies in their intention to support decision making for people with dementia, and had an overall perception that "a little effort goes a long way."

Creative arts research : a long path to acceptance

The majority of tertiary practice-led creative arts disciplines became part of the Australian university system as a result of the creation of the Unified National System of tertiary education in 1988. Over the past two decades, research has grown as the yardstick by which academic performance in the Australian university sector is recognised and rewarded. Academics in artistic disciplines, who struggled to adapt to a culture and workload expectations different from their previous, predominantly teaching based, employment, continue to see their research under-valued within the established evaluation framework. Despite a late 1990s Australian government funded inquiry, many of the inequities remain. While the Excellence in Research in Australia (ERA) exercise has acknowledged the non-text outputs of artist-academics in its evaluation of 'research outcomes', much of the process remains resolutely framed by measures that work against creative arts researchers.

Narrative and multimodality in English language arts curricula : a tale of two nations

In this policy column within this special edition on "The Arts in Language Arts", we critique the current place of multimodality and narratives in research and curriculum policy. This is a vital issue of significance for literacy educators, researchers, and policy makers because the narrative texts that circulate in our everyday lives are multimodal, tied to the ever-broadening range of narratives forms in digital sites of display. Here, we critically evaluate the place of multimodality and narratives in the language arts or English curriculum policies of two nations, the USA and Australia. In particular, we highlight the silence on multimodality within the Common Core State Standards, USA, and the contrasting centrality of multimodality in the National Curriculum: English, Australia.

Potentially inappropriate prescribing in older patients discharged from acute care hospitals to residential aged care facilities

Background The frequency of prescribing potentially inappropriate medications (PIMs) in older patients remains high despite evidence of adverse outcomes from their use. Little is known about whether admission to hospital has any effect on appropriateness of prescribing. Objectives This study aimed to identify the prevalence and nature of PIMs and explore the association of risk factors for receiving a PIM. Methods This was a prospective study of 206 patients discharged to residential aged care facilities (RACFs) from acute care. All patients were aged at least 70 years and were admitted between July 2005 and May 2010; their admission and discharge medications were evaluated. Results Mean patient age was 84.8 ± 6.7 years; the majority (57%) were older than 85 years and mean (SD) Frailty Index was 0.42 (0.15). At least one PIM was identified in 112 (54.4%) patients on admission and 102 (49.5%) patients on discharge. Of all medications prescribed at admission (1728), 10.8% were PIMs and at discharge of 1759 medications, 9.6% were PIMs. Of total 187 PIMs on admission, 56 (30%) were stopped and 131 were continued; 32 new PIMs were introduced. Of the potential risk factors considered, in-hospital cognitive decline and frailty status were the only significant predictors of PIMs. Conclusion Although, admission to hospital is an opportunity to review the indications for specific medications, a high prevalence of inappropriate drug use was observed. The only associations with PIM use were the frailty status and in-hospital cognitive decline. Additional studies are needed to further evaluate this association.

Potentially inappropriate prescribing in older patients admitted to acute care hospitals and discharged to residential aged care facilities

Background The frequency of prescribing potentially inappropriate medications (PIMs) in older patients remains high regardless of the evidence of adverse outcomes from their use. This study aims to identify the prevalence and nature of PIMs at admission to acute care and at discharge to residential aged care facilities (RACFs) using the recently updated Beers’ Criteria. We also aim to identify if polypharmacy, age, gender and the frailty status of patients are independent risk factors for receiving a PIM. Methods This was a retrospective study of 206 patients discharged to RACFs from acute care. All patients were aged at least70 years and were admitted between July 2005 and May 2010; their admission and discharge medications were evaluated. Frailty status was measured as the Frailty Index (FI), adding each individual’s deficits and dividing by the total number of deficits considered, with FI 0.25 used as the cut-off between “fit” and “frail”. Results Mean patient age was 84.8 ± 6.7 years; the majority (57%) were older than 85 years and approximately 90% were frail. Patients were prescribed a mean of 7.2 regular medications at admission and 8.1 on discharge. At least one PIM was identified in 112 (54.4%) patients on admission and 102 (49.5%) patients on discharge. Of all medications prescribed at admission (1728), 10.8% were PIMs and at discharge of 1759 medications, 9.6% were PIMs. Of the total 187 PIMs on admission, 56 (30%) were stopped, and 131 were continued; 32 new PIMs were introduced. Commonly prescribed PIMs at both admission and discharge were central nervous system, cardiovascular and gastrointestinal drugs and analgesics. Of the potential risk factors, frailty status was the only significant predictor of PIMs at both admission and discharge (p = 0.016). Conclusion A high prevalence of unnecessary drug use was observed in frail older patients on admission to acute care hospitals and on discharge to RACFs. The only association with PIM use was the frailty status of patients. Further studies are needed to further evaluate this association.