Double jeopardy : comorbid anxiety and depression in later life

Comorbid depression and anxiety in late life present challenges for geriatric mental health care providers. These challenges include identifying the often complex diagnostic presentations both clinically and in a research context. This potent comorbidity can be conceived as double jeopardy in older adults, further diminishing their quality of life. Geriatric health care providers need to understand psychiatric comorbidity of this type for accurate diagnosis and early referral to specialists, and to coordinate interdisciplinary care. Researchers in the field also need to recognize potential multiple impacts of comorbidities with respect to assessment and treatment domains. This article describes the prevalence of late-life depression and anxiety disorders and reviews studies on this comorbidity in older adults. Risk factors and protective factors for anxiety and depression in later life are reviewed, and information is provided about comparative symptoms, the selection of assessment tools, and challenges to the provision of interdisciplinary, evidence-based care.

Tailoring Consumer Resources to Enhance Self-Care in Chronic Heart Failure

Background Chronic heart failure (CHF) is associated with high hospitalisation and mortality rates and debilitating symptoms. In an effort to reduce hospitalisations and improve symptoms individuals must be supported in managing their condition. Patients who can effectively self-manage their symptoms through lifestyle modification and adherence to complex medication regimens will experience less hospitalisations and other adverse events. Aim The purpose of this paper is to explain how providing evidence-based information, using patient education resources, can support self-care. Discussion Self-care relates to the activities that individuals engage in relation to health seeking behaviours. Supporting self-care practices through tailored and relevant information can provide patients with resources and advice on strategies to manage their condition. Evidence-based approaches to improve adherence to self-care practices in patients with heart failure are not often reported. Low health literacy can result in poor understanding of the information about CHF and is related to adverse health outcomes. Also a lack of knowledge can lead to non-adherence with self-care practices such as following fluid restriction, low sodium diet and daily weighing routines. However these issues need to be addressed to improve self-management skills. Outcome Recently the Heart Foundation CHF consumer resource was updated based on evidence-based national clinical guidelines. The aim of this resource is to help consumers improve understanding of the disease, reduce uncertainty and anxiety about what to do when symptoms appear, encourage discussions with local doctors, and build confidence in self-care management. Conclusion Evidence-based CHF patient education resources promote self-care practices and early detection of symptom change that may reduce hospitalisations and improve the quality of life for people with CHF.

Knowledge translation for effective consumers

With the emergence of patient-centered care, consumers are becoming more effective managers of their care—in other words, “effective consumers.” To support patients to become effective consumers, a number of strategies to translate knowledge to action (KTA) have been used with varying success. The use of a KTA framework can be helpful to researchers and implementers when framing, planning, and evaluating knowledge translation activities and can potentially lead to more successful activities. This article briefly describes the KTA framework and its use by a team based out of the University of Ottawa to translate evidence-based knowledge to consumers. Using the framework, tailored consumer summaries, decision aids, and a scale to measure consumer effectiveness were created in collaboration with consumers. Strategies to translate the products into action then were selected and implemented. Evaluation of the knowledge tools and products indicates that the products are useful to consumers. Current research is in place to monitor the use of these products, and future research is planned to evaluate the effect of using the knowledge on health outcomes. The KTA framework provides a useful and valuable approach to knowledge translation.

Choosing landmarks for risky planning

This work examines the effect of landmark placement on the efficiency and accuracy of risk-bounded searches over probabilistic costmaps for mobile robot path planning. In previous work, risk-bounded searches were shown to offer in excess of 70% efficiency increases over normal heuristic search methods. The technique relies on precomputing distance estimates to landmarks which are then used to produce probability distributions over exact heuristics for use in heuristic searches such as A* and D*. The location and number of these landmarks therefore influence greatly the efficiency of the search and the quality of the risk bounds. Here four new methods of selecting landmarks for risk based search are evaluated. Results are shown which demonstrate that landmark selection needs to take into account the centrality of the landmark, and that diminishing rewards are obtained from using large numbers of landmarks.

Older drivers’ insight into their hazard perception ability

Even though the driving ability of older adults may decline with age, there is evidence that some individuals attempt to compensate for these declines using strategies such as restricting their driving exposure. Such compensatory mechanisms rely on drivers’ ability to evaluate their own driving performance. This paper focuses on one key aspect of driver ability that is associated with crash risk and has been found to decline with age: hazard perception. Three hundred and seven drivers, aged 65 to 96, completed a validated video-based hazard perception test. There was no significant relationship between hazard perception test response latencies and drivers’ ratings of their hazard perception test performance, suggesting that their ability to assess their own test performance was poor. Also, age related declines in hazard perception latency were not reflected in drivers’ self-ratings. Nonetheless, ratings of test performance were associated with self-reported regulation of driving, as was self-rated driving ability. These findings are consistent with the proposal that, while self-assessments of driving ability may be used by drivers to determine the degree to which they restrict their driving, the problem is that drivers have little insight into their own driving ability. This may impact on the potential road safety benefits of self-restriction of driving because drivers may not have the information needed to optimally self-restrict. Strategies for addressing this problem are discussed.

Cracking the code : a checklist to complement CRAs for first year Justice students

It is well recognised in the literature on first year higher education that there is a need for Universities to provide further support and development in student learning skills and engagement. Assessment and feedback is an area with differing expectations and understandings among academics and students (e.g. AUSSE, CEQ). Consistency and explicitness in academic feedback is fundamental in assisting students in their transition to university education and learning. This poster captures the progress of an 18 month funded by the Faculty of Law Teaching and Learning Grant scheme (QUT). The project sought to develop and trial an assessment checklist/diagnostic tool to accompany Criteria Referenced Assessment sheets for students within the School of Justice, Law Faculty, Queensland University of Technology (QUT).The checklist was trialled across four units in the School of Justice (Law faculty) amongst an estimated cohort of over 600 students undertaking single and dual degrees.

The enterprising artist and the arts entrepreneur : Emergent pedagogies for new disciplinary habits of mind

Traditional pedagogies in the arts in higher education focus largely on the studio experience in which a novice artist studies under one or more master teachers (e.g., Don, Garvey, & Sadeghpour, 2009). In more recent times, however, a shift in higher education curriculum and pedagogy in the arts has expanded this traditional conservatory model of training to include, among other components, career self-management and enterprise creation—in a word, entrepreneurship.This chapter examines the developing field of arts enterprise and arts entrepreneurship in higher education in a multinational context. The field is contextualized within the broader landscape of the creative industries and the consequential development of knowledge, skills, and the habits of mind necessary for artistic venture creation, sustainability, and success. Whereas the discourse about learning and teaching for business entrepreneurship is well established (e.g., Fiet, 2001), equivalent conversations about arts enterprise and entrepreneurship have only recently begun (Beckman, 2007, 2011; Essig, 2009). This chapter will address the contested definitions of key terms and concepts and also the question of how arts educators, although mindful of the pedagogic traditions of the arts school, are also drawing on the pedagogies of business entrepreneurship and cognitive theories of entrepreneurship to create innovative new transdisciplinary signature pedagogies for creative enterprise and entrepreneurship education in the arts.

Responsiveness of the Effective Consumer Scale (EC-17)

Objective. The Effective Consumer Scale (EC-17) comprises 17 items measuring the main skills and behaviors people need to effectively manage their healthcare. We tested the responsiveness of the EC-17. Methods. Participants, in 2 waves of a 6-week Arthritis Self-Management Program (ASMP) from Arthritis Ireland, received a questionnaire at the first and last week of the weekly ASMP. The questionnaire included the EC-17 and 10 other measures for arthritis. Deficits, mean change, and standard deviations were calculated at baseline and Week 6. The EC-17 scores were compared to the Arthritis Self-Efficacy (ASE) and Patient Activation Measure (PAM) scales. Results were presented at OMERACT 9. Results. There is some overlap between the EC-17 and the ASE and PAM; however, most items of greatest deficit in the EC-17 are not covered by those scales. In 327 participants representing both intervention waves (2006 and 2007), the EC-17 was more efficient than the ASE but less efficient than the PAM for detecting improvements after the ASMP, and was moderately correlated with the PAM. Conclusion. The EC-17 appears to measure different skills and attributes than the ASE and PAM. Discussions with participants at OMERACT 9 agreed that it is worthwhile to measure the skills and attributes of an effective consumer, and supported the development of an intervention (such as proposed online decision aids) that would include education in the categories in the EC-17.

Construction of Francophone families’ health literacy in a linguistic minority situation

With the increase in international mobility, healthcare systems should no longer be ignoring language barriers. In addition to the benefit of reducing long‐term costs, immigrant‐friendly organizations should be concerned with mitigating the way language barriers increase individuals’ social vulnerabilities and inequities in health care and health status. This paper reports the findings of a qualitative, exploratory study of the health literacy of 28 Francophone families living in a linguistic‐minority situation in Canada. Analysis of interviews revealed that participants’ social vulnerability, mainly due to their limited social and informational networks, influenced the construction of family health literacy. Disparities in access to healthcare services could be decreased by having health professionals’ work in alliance with Francophone community groups and by hiring bilingual health professionals. Linguistic isolation and lack of knowledge about local cultural organizations among Francophone immigrants were two important findings of this study

Restrung new chamber festival : an exploration of contemporary string practice

The Restrung New Chamber Festival was a practice-led research project which explored the intricacies of musical relationships. Specifically, it investigated the nature of contemporary string practice, with "New music" at its core. For the purposes of this project, "New music" will be defined in terms of representing a "global sonorous space" (Nancy 2007:12), which Hulse describes as "a spectacular comingling of styles and an unprecedented explosion of creative possibilities" (Hulse n.d.:2). Approaches to staging such an event are contextualised through a comparative analysis with relevant Australian and European festivals. The Restrung model derived inspiration from both art music and popular music festival models, in several aspects. One strategy was to engage audiences through combinations of musical, visual and spatial features. Another strategy was to encourage interaction by audiences with installations, workshops and forums. Restrung represents a new and distinctive model which presented art music within an immersive environment. This exegesis presents an evaluation framework which investigates the relationship between curatorial input and the experiential qualities of the festival. The context of an overview of trends in arts festival curation informs the discussion, as well as approaches to identifying new and receptive audiences. It is expected that the evaluation framework will provide a useful and practical guide for curators working in contemporary string practice, hybrid arts, experimental and cross-art form festival design.