'It had to be my choice' Indigenous smoking cessation and negotiations of risk, resistance and resilience

While Australia is considered a world leader in tobacco control, smoking rates within the Aboriginal and Torres Strait Islander population have not declined at the same rate. This failure highlights an obvious shortcoming of mainstream anti-smoking efforts to effectively understand and engage with the socio-cultural context of Indigenous smoking and smoking cessation experiences. The purpose of this article is to explore the narrative accounts of 20 Indigenous ex-smokers within an urban community and determine the motivators and enablers for successful smoking cessation. Our findings indicated that health risk narratives and the associated social stigma produced through anti-smoking campaigns formed part of a broader apparatus of oppression among Indigenous people, often inspiring resistance and resentment rather than compliance. Instead, a significant life event and supportive relationships were the most useful predictors of successful smoking cessation acting as both a motivator and enabler to behavioural change. Indigenous smoking cessation narratives most commonly involved changing and reordering a person’s life and identity and autonomy over this process was the critical building block to reclaiming control over nicotine addiction. Most promisingly, at an individual level, we found the important role that individual health professionals played in encouraging and supporting Indigenous smoking cessation through positive rather than punitive interactions. More broadly, our findings highlighted the central importance of resilience, empowerment, and trust within health promotion practice.

Prevalence of malnutrition in community-dwelling adults with Parkinson's disease

People with Parkinson’s disease (PD) have been reported to be at higher risk of malnutrition than an age-matched population due to PD motor and non-motor symptoms and pharmacotherapy side effects. The prevalence of malnutrition in PD has yet to be well-defined. Community-dwelling people with PD, aged > 18 years, were recruited (n = 97, 61 M, 36 F). The Patient-Generated Subjective Global Assessment (PGSGA) was used to assess nutritional status, the Parkinson’s Disease Questionnaire (PDQ-39) was used to assess quality of life, and the Beck’s Depression Inventory (BDI) was used to measure depression. Levodopa equivalent doses (LEDs) were calculated based on reported Parkinson’s disease medication. Weight, height, mid-arm circumference (MAC) and calf circumference were measured. Cognitive function was measured using the Addenbrooke’s Cognitive Examination. Average age was 70.0 (9.1, 35–92) years. Based on SGA, 16 (16.5%) were moderately malnourished (SGA B) while none were severely malnourished (SGA C). The well-nourished participants (SGA A) had a better quality of life, t(90) = −2.28, p < 0.05, and reported less depressive symptoms, t(94)= −2.68, p < 0.05 than malnourished participants. Age, years since diagnosis, cognitive function and LEDs did not signifi cantly differ between the groups. The well-nourished participants had lower PG-SGA scores, t(95) = −5.66, p = 0.00, higher BMIs, t(95) = 3.44, p < 0.05, larger MACs, t(95) = 3.54, p < 0.05 and larger calf circumferences, t(95) = 2.29, p < 0.05 than malnourished participants. Prevalence of malnutrition in community-dwelling adults with PD in this study is comparable to that in other studies with community-dwelling adults without PD and is higher than other PD studies where a nutritional status assessment tool was used. Further research is required to understand the primary risk factors for malnutrition in this group.

Risk factors for malnutrition in community-dwelling people with Parkinson’s disease

In the elderly, the risks for protein-energy malnutrition from older age, dementia, depression and living alone have been well-documented. Other risk factors including anorexia, gastrointestinal dysfunction, loss of olfactory and taste senses and early satiety have also been suggested to contribute to poor nutritional status. In Parkinson’s disease (PD), it has been suggested that the disease symptoms may predispose people with PD to malnutrition. However, the risks for malnutrition in this population are not well-understood. The current study’s aim was to determine malnutrition risk factors in community-dwelling adults with PD. Nutritional status was assessed using the Patient-Generated Subjective Global Assessment (PG-SGA). Data about age, time since diagnosis, medications and living situation were collected. Levodopa equivalent doses (LDED) and LDED per kg body weight (mg/kg) were calculated. Depression and anxiety were measured using the Beck’s Depression Inventory (BDI) and Spielberger Trait Anxiety questionnaire, respectively. Cognitive function was assessed using the Addenbrooke’s Cognitive Examination (ACE-R). Non-motor symptoms were assessed using the Scales for Outcomes in Parkinson's disease-Autonomic (SCOPA-AUT) and Modified Constipation Assessment Scale (MCAS). A total of 125 community-dwelling people with PD were included, average age of 70.2±9.3(35-92) years and average time since diagnosis of 7.3±5.9(0–31) years. Average body mass index (BMI) was 26.0±5.5kg/m2. Of these, 15% (n=19) were malnourished (SGA-B). Multivariate logistic regression analysis revealed that older age (OR=1.16, CI=1.02-1.31), more depressive symptoms (OR=1.26, CI=1.07-1.48), lower levels of anxiety (OR=.90, CI=.82-.99), and higher LDED per kg body weight (OR=1.57, CI=1.14-2.15) significantly increased malnutrition risk. Cognitive function, living situation, number of prescription medications, LDED, years since diagnosis and the severity of non-motor symptoms did not significantly influence malnutrition risk. Malnutrition results in poorer health outcomes. Proactively addressing the risk factors can help prevent declines in nutritional status. In the current study, older people with PD with depression and greater amounts of levodopa per body weight were at increased malnutrition risk.

Malnutrition in a sample of community-dwelling people with Parkinson’s disease

Objective: Malnutrition results in poor health outcomes, and people with Parkinson’s disease may be more at risk of malnutrition. However, the prevalence of malnutrition in Parkinson’s disease is not yet well defined. The aim of this study is to provide an estimate of the extent of malnutrition in community-dwelling people with Parkinson’s disease. Methods: This is a cross-sectional study of people with Parkinson’s disease residing within a 2 hour driving radius of Brisbane, Australia. The Subjective Global Assessment (SGA) and scored Patient Generated Subjective Global Assessment (PG-SGA) were used to assess nutritional status. Body weight, standing or knee height, mid-arm circumference and waist circumference were measured. Results: Nineteen (15%) of the participants were moderately malnourished (SGA-B). The median PG-SGA score of the SGA-B group was 8 (4 – 15), significantly higher than the SGA-A group, U=1860.5,p<.05. The symptoms most influencing intake were loss of appetite, constipation, early satiety and problems swallowing. Conclusions: As with other populations, malnutrition remains under-recognised and undiagnosed in people with Parkinson’s disease. Regular screening of nutritional status in people with Parkinson’s disease by health professionals with whom they have regular contact should occur to identify those who may benefit from further nutrition assessment and intervention.

The late discovery of adoptive and donor insemination offspring status : ethical implications for conceptual understandings of the ‘best interests of the child’ principle

Late discovery is a term used to describe the experience of discovering the truth of one’s genetic origins as an adult. Following discovery, late discoverers face a lack of recognition and acknowledgment of their concerns from family, friends, community and institutions. They experience pain, anger, loss, grief and frustration. This presentation shares the findings of the first qualitative study of both late discovery of adoptive and donor insemination offspring (heterosexual couple use only) experiences. It is also the first study of late discovery experiences undertaken from an ethical perspective. While this study recruited new participants, it also included an ethical re-analysis of existing late discovery accounts across both practices. The findings of this study (a) draws links between past adoption and current donor insemination (heterosexual couple only) practices, (b) reveals that late discoverers are demanding acknowledgment and recognition of the particularity of their experiences, and (c) offers insights into conceptual understandings of the ‘best interests of the child’ principle. These insights derive from the lived experiences of those whose biological and social worlds have been sundered and secrecy and denial of difference used to conceal this. It suggests that acknowledging the equal moral status of the child may be useful in strengthening conceptual understandings of the ‘best interests of the child’ principle. This equal moral status involves ensuring that personal autonomy and the ability to exercise free will is protected; that the integrity of the relationships of trust expected and demanded between parent/s and children is defended and supported; and that equal access to normative socio-cultural practices, that is; non-fictionalised birth certificates and open records, is guaranteed.

Comparison of two methods to assess malnutrition in community-dwelling people with Parkinson's disease

Nutritional status in people with Parkinson’s disease (PD) has previously been assessed in a number of ways including BMI, % weight loss and the Mini-Nutritional Assessment(MNA). The symptoms of the disease and the side effects of medication used to manage them result in a number of nutrition impact symptoms that can negatively influence intake. These include chewing and swallowing difficulties, lack of appetite, nausea, and taste and smell changes, among others. Community-dwelling people with PD, aged >18 years, were recruited (n=97, 61 M, 36 F). The Patient-Generated Subjective Global Assessment(PG-SGA) and (MNA) were used to assess nutritional status. Weight, height, mid-arm circumference(MAC) and calf circumference were measured. Based on SGA, 16(16.5%) were moderately malnourished (SGA B) while none were severely malnourished (SGA C). The MNA identified 2(2.0%) as malnourished and 22(22.7%) as at risk of malnutrition. Mean MNA scores were different between the three groups,F(2,37)=7.30,p<.05 but not different between SGA B (21.0(2.9)) and MNA at risk (21.8(1.4)) participants. MAC and calf circumference were also different between the three groups,F(2,37)=5.51,p<.05 and F(2,37)=15.33,p<.05 but not between the SGA B (26.2(4.2), 33.3(2.8)) and MNA at risk (28.4(5.6), 36.4(4.7)) participants. The MNA results are similar to other PD studies using MNA where prevalence of malnutrition was between 0-2% with 20-33% at risk of malnutrition. In this population, the PG-SGA may be more sensitive to assessing malnutrition where nutrition impact symptoms influence intake. With society’s increasing body size, it might also be more appropriate as it does not rely on MAC and calf circumference measures.

Community wide interventions for increasing physical activity (protocol)

This is the protocol for a review and there is no abstract. The objectives are as follows: Primary research objective To determine the effects of community wide, multi-strategic interventions upon community levels of physical activity. Secondary research objectives 1. To explore whether any effects of the intervention are different within and between populations, and whether these differences form an equity gradient. 2. To describe other health (e.g. cardiovascular disease morbidity) and behavioural effects (e.g. diet) where appropriate outcomes are available. 3. To explore the influence of context in the design, delivery, and outcomes of the interventions. 4. To explore the relationship between the number of components, duration, and effects of the interventions. 5. To highlight implications for further research and research methods to improve knowledge of the interventions in relation to the primary research objective.

Engaging complexity through collaborative brand design

In this research we used inductive reasoning through design to understand how stakeholders in the Waterfall Way (New South Wales, Australia) perceive the relationships between themselves and the place they live in. This paper describes a collaborative design methodology used to release information about local identities, which guided the regional brand exercise. The methodology is explicit about the uncertainties and complexities of the design process and of its reception system. As such, it aims to engage with local stakeholders and experts in order to help elicit tacit knowledge and identify system patterns and trends that would possibly not be visible if a top-down expert-based process was used. Through collective design, local people were drawn together in search for a symbol to represent the meaning attached to their places/region in relation to sustainable tourism activity.

Diversification for sustainable development in rural and regional Australia : how local community leaders conceptualise the impacts and opportunities from agriculture, tourism and mining

Although the multiple economic, environmental and social challenges threatening the viability of rural and regional communities in Australia are well-known, little research has explored how community leaders conceptualise the impact and opportunities associated with economic diversification from agriculture into alternative industries, such as tourism and mining. This qualitative research, utilising the Darling Downs in Queensland as a case study, documents how 28 local community leaders have experienced this economic diversification process. The findings reveal that local community leaders have a deep understanding about the opportunities and challenges presented by diversification, articulating a clear vision about how to achieve the best possible future for their region. Despite excitement about growth, there were concerns about preserving heritage, the increased pressure on local infrastructure and an ageing population. By documenting local leader’s insights, these findings may help inform planning for rural and regional communities and facilitate management of the exciting yet challenging process of growth and diversification

"Fair" government contracts for community service provision : time to curb unfettered executive freedom?

All Australian governments are significantly increasing the use of contracted community service provision through not for profit (NFP) organisations. These transactions occur through grant arrangements which take the form of standard contracts or deeds rather than drawing on statutory authority. Government inquiries bodies have consistently reported and raised concerns about the fairness of such standard grant contract terms, but failed to provide any mechanism whereby fairness can be assured. The Productivity Commission has suggested that the resulting poor relationship results in inappropriate risk transfer, micro-management, disincentives to innovate and poor service provision. This paper develops and tests a fairness measure based on the principles of the Australian Consumer Law which legislates fairness protections for standard consumer contracts.  

Learning personalized tag ontology from user tagging information

The cross-sections of the Social Web and the Semantic Web has put folksonomy in the spot light for its potential in overcoming knowledge acquisition bottleneck and providing insight for "wisdom of the crowds". Folksonomy which comes as the results of collaborative tagging activities has provided insight into user's understanding about Web resources which might be useful for searching and organizing purposes. However, collaborative tagging vocabulary poses some challenges since tags are freely chosen by users and may exhibit synonymy and polysemy problem. In order to overcome these challenges and boost the potential of folksonomy as emergence semantics we propose to consolidate the diverse vocabulary into a consolidated entities and concepts. We propose to extract a tag ontology by ontology learning process to represent the semantics of a tagging community. This paper presents a novel approach to learn the ontology based on the widely used lexical database WordNet. We present personalization strategies to disambiguate the semantics of tags by combining the opinion of WordNet lexicographers and users’ tagging behavior together. We provide empirical evaluations by using the semantic information contained in the ontology in a tag recommendation experiment. The results show that by using the semantic relationships on the ontology the accuracy of the tag recommender has been improved.

Developing authentic professional knowledge through transformative community engagement in an interdisciplinary service learning project

This showcase presents a preliminary analysis of a community service learning project designed to align more authentically with contemporary society and emerging constructs of professional knowledge. As described in the paper, the project involves a multidisciplinary group of students working collaboratively with a community organisation to find creative presponses to challenging issues concerning the organisation's identity, how it interfaces with stakeholders, and how it evidences its inclusive practice. Of particular interest is how the interdisciplinary practice of the students within a service learning context encouraged reconsideration of their world0view and their rols as future professionals. Also highlighted is the need for greater congruence between the goals of the project and the structural elements of the curriculum.

Designing locative and social media technologies for community collaboration and social benefit : PetSearch

The convergence of locative and social media with collaborative interfaces and data visualisation has expanded the potential of online information provision. Offering new ways for communities to share contextually specific information, it presents the opportunity to expand social media’s current focus on micro self-publishing with applications that support communities to actively address areas of local need. This paper details the design and development of a prototype application that illustrates this potential. Entitled PetSearch, it was designed in collaboration with the Animal Welfare League of Queensland to support communities to map and locate lost, found and injured pets, and to build community engagement in animal welfare issues. We argue that, while established approaches to social and locative media provide a useful foundation for designing applications to harness social capital, they must be re-envisaged if they are to effectively facilitate community collaboration. We conclude by arguing that the principles of user engagement and co-operation employed in this project can be extrapolated to other online approaches that aim to facilitate co-operative problem solving for social benefit.

Narratives of the 'everyday' in Rio de Janeiro's favelas : community photographers' attempts at generating alternative news values [Narrativas do cotidiano nas favelas do Rio de Janeiro: tentativas de construção de valores-notícia alternativos pelos fotógrafos populares]

Abstract This paper presents the partial results of an ongoing research project which investigates ethnographically community (photo)journalism media initiatives, in Rio de Janeiro, Brazil. The Viva Rio and Observatorio de Favelas (NGOs) run projects that provide favela residents with skills to take, edit and print their own (photo) journalism contents that enables community-based framing and documentation of favela live, personalities and issues. Three months of fieldwork related to these projects in Rio's favelas generated remarkable theoretical issues that represent the community photographers' attempt to establish counter news values by shifting the focus from poverty, shortages, violence and criminality to images of the ordinary life which included the myriad events that occurs in the day of the favelas. Resumo Este artigo apresenta os resultados parciais de uma pesquisa em andamento que, a partir do método etnográfico, investiga os projetos de comunicação comunitária, jornalismo e fotojornalismo, no Rio de Janeiro, Brasil. As organizações não-governamentais (ONGs) Viva Rio e Observatório de Favela apoiam projetos que objetivam tornar moradores de favelas capazes de produzir, editar e publicar as suas próprias narrativas sobre personagens e questões do cotidiano de suas comunidades. O trabalho de campo sobre estes projetos, realizado durante três meses nas favelas do Rio de Janeiro, forneceu questões teóricas relevantes que representam o esforço dos fotógrafos populares para estabelecer contra valores-notícia transferindo o foco da pobreza, escassez, violência e criminalidade para imagens do cotidiano que inclui uma miríade de eventos que acontecem no dia-a-dia das favelas.