Review of refugee mental health interventions following resettlement : best practice and recommendations

There are increasing numbers of refugees worldwide, with approximately 16 million refugees in 2007 and over 2.5 million refugees resettled in the United States since the start of its humanitarian program. Psychologists and other health professionals who deliver mental health services for individuals from refugee backgrounds need to have confidence that the therapeutic interventions they employ are appropriate and effective for the clients with whom they work. The current review briefly surveys refugee research, examines empirical evaluations of therapeutic interventions in resettlement contexts, and provides recommendations for best practices and future directions in resettlement countries. The resettlement interventions found to be most effective typically target culturally homogeneous client samples and demonstrate moderate to large outcome effects on aspects of traumatic stress and anxiety reduction. Further evaluations of the array of psychotherapeutic, psychosocial, pharmacological, and other therapeutic approaches, including psychoeducational and community-based interventions that facilitate personal and community growth and change, are encouraged. There is a need for increased awareness, training and funding to implement longitudinal interventions that work collaboratively with clients from refugee backgrounds through the stages of resettlement.

Is there a place for pixels in our practice? Dietitians' attitudes towards the use of photographic dietary records within the nutrition care process

Photographic records of dietary intake (PhDRs) are an innovative method for the dietary assessment and may alleviate the burden of recording intake compared to traditional methods of recording intake. While the performance of PhDRs has been evaluated, no investigation into the application of this method had occurre within dietetic practice. This study examined the attitudes of dietitians towards the use of PhDRs in the provision of nutrition care. A web-based survey on the practices and beliefs with regards to technology use among Dietitians Association of Australia members was conducted in August 2011. Of the 87 dietitians who responded, 86% assessed the intakes of clients as part of individualised medical nutrition therapy, with the diet history the most common method used. The majority (91%) of dietitians surveyed believed that a PhDR would be of use in their current practice to estimate intake. Information contained in the PhDR would primarily be used to obtain a qualitative evaluation of diet (84%) or to supplement an existing assessment method (69%), as opposed to deriving an absolute measure of nutrient intake (31%). Most (87%) indicated that a PhDR would also be beneficial in both the delivery of the intervention and to evaluate and monitor goals and outcomes, while only 46% felt that a PhDR would assist in determining the nutrition diagnosis. This survey highlights the potential for the use of PhDRs within practice. Future endeavours lie in establishing resources which support the inclusion of PhDRs within the nutrition care process.

Attribution of words versus attribution of responsibilities : Academic plagiarism and university practice

This paper examines a case of academic plagiarism and the subsequent treatment of the issues across several academic institutions. It calls for academic leaders in universities to act on what constitutes a serious breach of standards, engendered in part by broader institutional norms and values promoting the need for publications in a ‘publish or perish’ environment. While universities often promote high-sounding ideals and would generally wish to be seen to uphold high academic standards, it is argued that silence and complicity surround the way in which instances of plagiarism in academic publications are often dealt with. Actions (and inaction) by academic leaders in universities in dealing with cases of academic plagiarism speak volumes in terms of the values academic institutions profess, and those they actually uphold. The paper prompts readers to consider the need for a more consistent and proactive stance on the part of their own institutions to exercise ethical leadership in identifying and addressing academic plagiarism when it occurs.

Making space for knowledge generation and place for knowledge communities : an analysis of the Australian practice

In the era of global knowledge economy, urban regions—seeking to increase their competitive edge, become destinations for talent and investment, and provide prosperity and quality of life to their inhabitants—have little chance achieving their development goals without forming effective knowledge-based urban development strategies. This paper aims to shed light on the planning and development processes of the knowledge-based urban development phenomenon with respect to the construction of knowledge community precincts aimed at making space for knowledge generation and place for knowledge communities. Following to a thorough review of the literature on knowledge-based urban development and strategic asset-based planning, the paper undertakes policy and best practice analyses to learn from the planning and development processes of internationally renowned knowledge community precincts—from Copenhagen, Eindhoven and Singapore. In the light of the analyses findings, this paper scrutinises major Australian knowledge community precinct initiatives—from Sydney, Melbourne and Brisbane—to better understand the dynamics of national practices, and benchmark them against the international best practice cases. The paper concludes with a discussion on the study findings and recommendations for successfully establishing space and place for both knowledge economy and society in Australian cities.

Students’ beliefs about willingness to access complementary and alternative therapies (CAT) training for future integration into psychology practice.

It is suggested that all psychologists gain basic training in the types of complementary and alternative therapies (CAT) their clients may be using. As psychology students are the next cohort of health professionals who will inform future initiatives in the field, it is important to first understand the factors which influence their decisions about CAT integration. Drawing on the Theory of Planned Behavior, we investigated the beliefs that differentiate between psychology students who are high or low on willingness to access training in CAT for future practice use. Psychology students (N = 106) completed a questionnaire assessing the likelihood of both positive and negative consequences of accessing training and utilizing CAT within a psychological practice, important others approval, and barriers preventing them from this integration behavior. Those students high compared to low on willingness more likely to endorse positive outcomes (e.g., offering a more holistic approach to therapy) of accessing CAT training for future practice use and to believe that important others (e.g., clients) would support this behavior. We identified important beliefs of student psychologists related to decisions about undertaking CAT training for future professional use and can inform educators and policy-makers about CAT training and integration in psychology practice.

Reasonable adjustments in assessment : putting law and policy into practice in Australia

The Australian Disability Standards for Education 2005 (Cth) require education providers to make reasonable adjustments in educational assessment so that students with disability can participate on the same basis as other students and be able to demonstrate what they know and can do. Reasonableness is governed by a determination of the balance of interests, benefits and detriment to the parties involved. The Standards require providers to consult with students and associates on adjustments, although guidance on how consultation should occur and how the views of students and associates are to be taken into account is vague. In this article, we identify three principles to be considered in order to put appropriate and effective reasonable adjustments in assessment into practice. While Australian law and assessment contexts are used to examine intentions, expectations and practices in educational assessment for students with disability, we argue that these three principles must be considered in any national education system to ensure equitable assessment practices and achieve equitable educational inclusion for students with disability.

From tiers to tables – enhancing student experience through collaborative learning spaces

BACKGROUND Collaborative and active learning have been clearly identified as ways students can engage in learning with each other and the academic staff. Traditional tier based lecture theatres and the didactic style they engender are not popular with students today as evidenced by the low attendance rates for lectures. Many universities are installing spaces designed with tables for group interaction with evolutions on spaces such as the TEAL (Technology Enabled Active Learning) (Massachusetts Institute of Technology, n.d.) and SCALE-UP (Student-Centred Activities for Large-Enrolment Undergraduate Programs) (North Carolina State University, n.d.) models. Technology advances in large screen computers and applications have also aided the move to these collaborative spaces. How well have universities structured learning using these spaces and how have students engaged with the content, technology, space and each other? This paper investigates the application of collaborative learning in such spaces for a cohort of 800+ first year engineers in the context of learning about and developing professional skills representative of engineering practice. PURPOSE To determine whether moving from tiers to tables enhances the student experience. Does utilising technology rich, activity based, collaborative learning spaces lead to positive experiences and active engagement of first year undergraduate engineering students? In developing learning methodology and approach in new learning spaces, what needs to change from a more traditional lecture and tutorial configuration? DESIGN/METHOD A post delivery review and analysis of outcomes was undertaken to determine how well students and tutors engaged with learning in new collaborative learning spaces. Data was gathered via focus group and survey of tutors, students survey and attendance observations. The authors considered the unit delivery approach along with observed and surveyed outcomes then conducted further review to produce the reported results. RESULTS Results indicate high participation in the collaborative sessions while the accompanying lectures were poorly attended. Students reported a high degree of satisfaction with the learning experience; however more investigation is required to determine the degree of improvement in retained learning outcomes. Survey feedback from tutors found that students engaged well in the activities during tutorials and there was an observed improvement in the quality of professional practice modelled by students during sessions. Student feedback confirmed the positive experiences in these collaborative learning spaces with 30% improvement in satisfaction ratings from previous years. CONCLUSIONS It is concluded that the right mix of space, technology and appropriate activities does engage students, improve participation and create a rich experience to facilitate potential for improved learning outcomes. The new Collaborative Teaching Spaces, together with integrated technology and tailored activities, has transformed the delivery of this unit and improved student satisfaction in tutorials significantly.

Mobility and active ageing in suburban environments : findings from in-depth interviews and person-based GPS tracking

Background. Governments face a significant challenge to ensure that community environments meet the mobility needs of an ageing population. Therefore, it is critical to investigate the effect of suburban environments on the choice of transportation and its relation to participation and active ageing. Objective. This research explores if and how suburban environments impact older people’s mobility and their use of different modes of transport. Methods. Data derived from GPS tracking, travel diaries, brief questionnaires, and semistructured interviews were gathered from thirteen people aged from 56 to 87 years, living in low-density suburban environments in Brisbane, Australia. Results. The suburban environment influenced the choice of transportation and out-of-home mobility. Both walkability and public transportation (access and usability) impact older people’s transportation choices. Impracticality of active and public transportation within suburban environments creates car dependency in older age. Conclusion. Suburban environments often create barriers to mobility, which impedes older people’s engagement in their wider community and ability to actively age in place. Further research is needed to develop approaches towards age-friendly suburban environments which will encourage older people to remain active and engaged in older age.

Delineating the practice profile of advanced practice nursing : a cross-sectional survey using the modified strong model of advanced practice

AIMS: To test a model that delineates advanced practice nursing from the practice profile of other nursing roles and titles. BACKGROUND: There is extensive literature on advanced practice reporting the importance of this level of nursing to contemporary health service and patient outcomes. Literature also reports confusion and ambiguity associated with advanced practice nursing. Several countries have regulation and delineation for the nurse practitioner, but there is less clarity in definition and service focus of other advanced practice nursing roles. DESIGN: A statewide survey. METHODS: Using the modified Strong Model of Advanced Practice Role Delineation tool, a survey was conducted in 2009 with a random sample of registered nurses/midwives from government facilities in Queensland, Australia. Analysis of variance compared total and subscale scores across groups according to grade. Linear, stepwise multiple regression analysis examined factors influencing advanced practice nursing activities across all domains. RESULTS: There were important differences according to grade in mean scores for total activities in all domains of advanced practice nursing. Nurses working in advanced practice roles (excluding nurse practitioners) performed more activities across most advanced practice domains. Regression analysis indicated that working in clinical advanced practice nursing roles with higher levels of education were strong predictors of advanced practice activities overall. CONCLUSION: Essential and appropriate use of advanced practice nurses requires clarity in defining roles and practice levels. This research delineated nursing work according to grade and level of practice, further validating the tool for the Queensland context and providing operational information for assigning innovative nursing service.

Using the Donabedian framework to examine the quality and safety of nursing service innovation

Aims and objectives To evaluate the safety and quality of nurse practitioner service using the audit framework of Structure,Process and Outcome. Background Health service and workforce reform are on the agenda of governments and other service providers seeking to contain healthcare costs whilst providing safe and effective health care to communities. The nurse practitioner service is one health workforce innovation that has been adopted globally to improve timely access to clinical care, but there is scant literature reporting evaluation of the quality of this service innovation. Design. A mixed-methods design within the Donabedian evaluation framework was used. Methods The Donabedian framework was used to evaluate the Structure, Process and Outcome of nurse practitioner service. A range of data collection approaches was used, including stakeholder survey (n=36), in-depth interviews (11 patients and 13 nurse practitioners) and health records data on service processes. Results The study identified that adequate and detailed preparation of Structure and Process is essential for the successful implementation of a service innovation. The multidisciplinary team was accepting of the addition of nurse practitioner service, and nurse practitioner clinical care was shown to be effective, satisfactory and safe from the perspective of the clinician stakeholders and patients. Conclusions This study demonstrated that the Donabedian framework of Structure, Process and Outcome evaluation is a valuable and validated approach to examine the safety and quality of a service innovation. Furthermore, in this study, specific Structure elements were shown to influence the quality of service processes further validating the framework and the interdependence of the Structure, Process and Outcome components. Relevance to clinical practice Understanding the structure and process requirements for establishing nursing service innovation lays the foundation for safe, effective and patient-centred clinical care.

Evolving and expanding : the scope of practice of the infection control practitioner

Infection control practitioners (ICPs) work across the full spectrum of health care settings and carry out a broad range of practice activities. Whilst several studies have reported on the role of the ICP, there has been little investigation of the scope of infection control practice. This knowledge is essential to inform the professional, legal, educational and financial implications of this specialist role. One hundred and thirteen ICPs from a range of health care settings across Queensland were surveyed. Respondents were asked to rate the extent to which they were and should be engaging in the range of practices identified by Gardner, Jones & Olesen (1999). Significant differences were evident between what ICPs said was their actual practice versus what they thought they should be doing. Overall, the respondents consistently reported that they should be engaging in more of the range of infection control activities than they were, particularly with regard to management practices. A number of differences were found according to the context in which the practitioners worked, such as the type and size of facility and their employment status. The results of this study indicate that the scope of infection control practice has clearly moved beyond those practices that are confined by the hospital wall and defined by surveillance activities.