Prevalence of malnutrition risk and its relationship with risk factors of hospital re-admission in older adults

Background: Risk of malnutrition in older people continues to be a global problem. Malnutrition is often unrecognized and under-treated across health care settings and may result in undesirable health consequences, impaired recovery from illness and a poorer quality of life. Aim: This study aimed to determine the prevalence of malnutrition risk in a sample of older people at high risk of hospital re-admission. The association between risk factors of hospital re-admission and risk of malnutrition were also explored. Methods: One hundred and twenty five hospitalised patients aged 65 years and older at risk of hospital readmission (24% male, 76% female, mean age 77 ± 6 years) were recruited from a tertiary metropolitan hospital in Australia. The valid and reliable Malnutrition Screen Tool (MST) was employed to screen for malnutrition risk. It consists of two questions related to recent weight loss and appetite. Results: Prevalence of older adults at risk of malnutrition was 27.4%. Risk of malnutrition was not associated with age, gender and living arrangement. However, among risk factors of hospital readmission, lack of social support (χ2 = 4.18, N = 125, p = 0.028), and fair –poor self-rating of health (χ2 = 4.13, N = 125, p = 0.042) were statistically significant associated with risk of malnutrition. Conclusion: Risk of malnutrition in older people continues to be a concern in health care, and increasing psycho social support may help shed light on reducing risk of malnutrition.

The role of physical activity in the lives of people with lymphoedema following cancer treatment : a social constructionist study

Lymphoedema is a chronic condition predominantly affecting the limbs, although it can involve the trunk and other areas of the body. It is characterised by swelling due to excess accumulation of fluid in body tissues. Secondary lymphoedema, which arises following cancer treatment, is the more common form of lymphoedema in developed countries. At least 20% of those diagnosed with the most common cancers will develop lymphoedema. This is a concern in Australia as incidence of these cancers is increasing. Cancer survival rates are also increasing. Currently, this equates to 9 300 new cases of secondary lymphoedema diagnosed each year. Considerable physical and psychosocial impacts of lymphoedema have been reported and its subsequent impact on health-related quality of life can exacerbate other side effects of cancer treatment. Exercise following cancer treatment has been shown to significantly reduce the impact of treatment side effects, improve quality of life and physical status. While participating in exercise does not increase risk nor exacerbate existing lymphoedema, reductions in incidence of lymphoedema exacerbations and associated symptoms have been observed in women participating in regular weight lifting following breast cancer treatment. Despite these benefits, lymphoedema prevention and management advice cautions people with lymphoedema against „repetitive use. or „overuse. of their affected arm. It is possible that this advice creates a barrier to participation in physical activity; however, little is known about the relationship between physical activity and lymphoedema. In addition, the majority of studies examining the experiences of people living with lymphoedema and the impact of the condition have been predominantly conducted internationally and have focused on women following breast cancer. This study sought to explore firstly, how men and women construct their experience of living with lymphoedema following treatment for a range of cancers in the context of everyday life in Australia; and secondly, to analyse the role of physical activity in the lives of those living with lymphoedema following cancer treatment. A social constructivist grounded theory approach was taken to explore these objectives as it is acknowledged that human actions and the meanings associated with these actions are influenced by the interaction between the self and the social world. It is also acknowledged that the research process itself is a social construction between the researcher and participant. Purposive sampling techniques were used to recruit a total of 29 participants from a variety of sources. Telephone interviews and focus groups were conducted to collect data. Data were concurrently collected and analysed and analysis was conducted using the constant comparative method. The core category that developed in objective one was „sense of self‟. The self was defined by perceptions participants held of themselves and their identity prior to a lymphoedema diagnosis and changes to their perceptions and identity since diagnosis. Three conceptual categories which related to each other and to „sense of self‟ were developed through the process of coding that represented the process of how participants constructed their experiences living with secondary lymphoedema in the context of everyday life. Firstly, altered normalcy reflected the physical and psychosocial changes experienced and the effect it had on their lives. Secondly, „accidental journey‟ reflected participants‟ journey with the heath care system prior to diagnosis through to longer term management. Thirdly, renegotiating control revealed participants perceived control over lymphoedema and their ability to participate in daily activities previously enjoyed. These findings revealed the failure of the broader health system to recognise the significant and chronic nature of a lymphoedema diagnosis following cancer treatment with greater understanding, knowledge and support from health professionals being needed. The findings also reveal access to health professionals trained in lymphoedema management, a comprehensive approach encompassing both physical and psychosocial needs and provision of practical and meaningful guidelines supported by scientific evidence would contribute to improved treatment and management of the condition. The key findings for objective two were that people with lymphoedema define physical activity in different ways. Physical activity post-diagnosis was perceived as important by most for a variety of reasons ranging from everyday functioning, to physical and psychosocial health benefits. Issues relating to the impact of lymphoedema on physical activity related to the impact on peoples‟ ability to be physically active, confusion about acceptable forms of physical activity and barriers that lymphoedema presented to being physically active. A relationship between how people construct their experiences with lymphoedema and the role of physical activity was also established. The contribution of physical activity to the lives of people living with lymphoedema following cancer treatment appeared to be influenced by their sense of self as socially constructed through their experiences prior to diagnosis and following diagnosis with lymphoedema. The influence of pre-lymphoedema habits, norms and beliefs suggests the importance of effective health promotion messages to encourage physical activity among the general population and specific messages and guidelines particular to the needs of those diagnosed with lymphoedema following cancer treatment. The influence of participant.s social constructions on the lymphoedema experience highlights the importance of improving interactions between the overall health care system and patients, providing a clear treatment plan, providing evidence-based and clear advice about participation in appropriate physical activity, which in doing so will limit the physical and psychosocial effect of lymphoedema and providing comprehensive physical and psychosocial support to those living with the condition and their families. This study has contributed to a deep understanding of people.s experiences with lymphoedema following cancer treatment and the role of physical activity in the context of daily life in Australia. Findings from this study lead to recommendations for advocacy, a comprehensive approach to diagnosis, treatment and management, and specific areas for future research.

Studying Mobile Media : Cultural Technologies, Mobile Communication, and the iPhone

The iPhone represents an important moment in both the short history of mobile media and the long history of cultural technologies. Like the Walkman of the 1980s, it marks a juncture in which notions about identity, individualism, lifestyle and sociality require rearticulation. This book explores not only the iPhone’s particular characteristics, uses and "affects," but also how the "iPhone moment" functions as a barometer for broader patterns of change. In the iPhone moment, this study considers the convergent trajectories in the evolution of digital and mobile culture, and their implications for future scholarship. Through the lens of the iPhone—as a symbol, culture and a set of material practices around contemporary convergent mobile media—the essays collected here explore the most productive theoretical and methodological approaches for grasping media practice, consumer culture and networked communication in the twenty-first century.

Studying the mobile : locating the field

Book Description: The iPhone represents an important moment in both the short history of mobile media and the long history of cultural technologies. Like the Walkman of the 1980s, it marks a juncture in which notions about identity, individualism, lifestyle and sociality require rearticulation. this book explores not only the iPhone’s particular characteristics, uses and "affects," but also how the "iPhone moment" functions as a barometer for broader patterns of change. In the iPhone moment, this study considers the convergent trajectories in the evolution of digital and mobile culture, and their implications for future scholarship. Through the lens of the iPhone—as a symbol, culture and a set of material practices around contemporary convergent mobile media—the essays collected here explore the most productive theoretical and methodological approaches for grasping media practice, consumer culture and networked communication in the twenty-first century.

Melbourne and Brisbane: The Claims of Suburbs

This chapter critiques the imagined geography of creative cities and the creative industries, which presumes that inner cities are densely clustered hubs of urban culture and creativity while suburbs are dull, homogeneous dormitories from which creative people must escape in order to realize their potential. Drawing upon a study on creative industries workers in Melbourne and Brisbane, the authors argue that these workers are as likely to be located in the suburbs as in the inner city, and that they clearly identify advantages to being in outer suburban locations. Their findings provide a corrective to dominant urban cultural policy narratives that stress cultural amenity in the inner cities.

Framing perspectives on design and ethics

This chapter discusses design thinking and design as a process which spans all spheres of everyday life.

Accounting at home in developing economies : Current practices and implications for the accounting professional

We determine the extent of accounting at home in developing economies in this research. We then consider the role of the accounting profession may have in promoting accounting values at home. A language of business, accounting today plays a fundamental support role within the business community to evaluate the impact past decisions, and foresees directions for future initiatives. Sound accounting practices are fundamental to ensure symmetrical information dissemination across various stakeholders. Accounting literature has sought to investigate a number of questions that attempt to improve the practice of accounting in the corporate world. Equally, we must obtain adequate understanding of how we use accounting in our everyday life, and how accounting could assist the people most affected by the effects of accounting scandals, economic conditions, and corporate collapses.

“A problem of versions” : laying down the law in the school playground

Purpose This chapter investigates an episode where a supervising teacher on playground duty asks two boys to each give an account of their actions over an incident that had just occurred on some climbing equipment in the playground. Methodology This paper employs an ethnomethodological approach using conversation analysis. The data are taken from a corpus of video recorded interactions of children, aged 7-9 years, and the teacher, in school playgrounds during the lunch recess. Findings The findings show the ways that children work up accounts of their playground practices when asked by the teacher. The teacher initially provided interactional space for each child to give their version of the events. Ultimately, the teacher’s version of how to act in the playground became the sanctioned one. The children and the teacher formulated particular social orders of behavior in the playground through multi-modal devices, direct reported speech and scripts. Such public displays of talk work as socialization practices that frame teacher-sanctioned morally appropriate actions in the playground. Value of paper This chapter shows the pervasiveness of the teacher’s social order, as she presented an institutional social order of how to interact in the playground, showing clearly the disjunction of adult-child orders between the teacher and children.

The performance and politics of practice for New Graduate Nurses

The change from nursing student to Registered Nurse (RNs) is both a desirable and anticipated event for New Graduate Nurses (NGNs). Having completed their formal education, most NGNs approach the threshold of their professional career with mixed emotions. While excited about the future and eagerly awaiting the commencement of employment, many are aware that this change also signifies a time of personal upheaval, professional insecurity and further personal learning. In the nursing professions’ enthusiasm to facilitate a smooth passage for NGNs a vast literature now addresses preparation-for-practice degrees, as well as the perceived workplace deficits and support needs of NGNs. However, the importance this change from working as a student to working as a NGN is not well conceptualised, theorised or understood as this largely instrumental literature essentially reduces the problematisation of the NGN transition experience to the problematisation of the individual by identifying NGNs as ‘the’ problem. Subsequently it fails to expose or challenge the normative assumptions underpinning processes that have formerly been considered solutions, or, the impact of such processes in a workplace that frames itself as “supportive”. Conspicuously absent is an exploration of how the NGN role is performed by former students, now beginning RNs undergoing the very personal transition of “becoming registered nurses”. Using Goffman’s (1956) theorisation of performance in everyday life exploring how process and meaning in mundane interactions present themselves in the “regular” lives of people at large, and Margaret Archer’s (2000) work emphasising the significance of the inner dialogue for managing the emotions that emerge out of situations that confront us, this paper draws upon data collected during a study of NGNs’ experience of transition to practice (Malouf 2010). It focuses on an emergent understanding of the need to differentiate the performance of ‘student’ from that of ‘NGN’ role. Further, it explores how these roles have become conflated into a conceptual continuum and viewed as a slide from student to NGN performance, rather than a significant moment of change involving roles that need to be distinctly defined as a necessary precursor to enhancing and supporting the professional and personal development of beginning practitioners.

Food and interaction design [Extended Abstract]

Food and interaction design presents an interesting challenge to the HCI community in attending to the pervasive nature of food, the socio-cultural differences in food practices and a changing global foodscape. To design for meaningful and positive interactions it is essential to identify daily food practices and the opportunities for the design of technology to support such practices. This workshop brings together a community of researchers and practitioners in human-food interaction to attend to the practical and theoretical difficulties in designing for human-food interactions in everyday life. Through a practical field study and workshop we explore themes of food experiences, health and wellbeing, sustainability and alternative food cultures.

Wayfinding : a simple concept, a complex process

Wayfinding is the process of finding your way to a destination in a familiar or unfamiliar setting using any cues given by the environment. Due to its ubiquity in everyday life, wayfinding appears on the surface to be a simply characterised and understood process, however this very ubiquity and the resulting need to refine and optimise wayfinding has lead to a great number of studies that have revealed that it is in fact a deeply complex exercise. In this paper we examine the motivations for investigating wayfinding, with particular attention being paid to the unique challenges faced in transportation hubs, and discuss the associated principles and factors involved as they have been perceived from different research perspectives.We also review the approaches used to date in the modelling of wayfinding in various contexts. We attempt to draw together the different perspectives applied to wayfinding and postulate the importance of wayfinding and the need to understand this seemingly simple, but concurrently complex, process.

The neglected dimension of community liveability : impact on social connectedness and active ageing in higher density accommodation

Purpose This thesis is about liveability, place and ageing in the high density urban landscape of Brisbane, Australia. As with other major developed cities around the globe, Brisbane has adopted policies to increase urban residential densities to meet the main liveability and sustainability aim of decreasing car dependence and therefore pollution, as well as to minimise the loss of greenfield areas and habitats to developers. This objective hinges on urban neighbourhoods/communities being liveable places, which residents do not have to leave for everyday living. Community/neighbourhood liveability is an essential ingredient in healthy ageing in place and has a substantial impact upon the safety, independence and well-being of older adults. It is generally accepted that ageing in place is optimal for both older people and the state. The optimality of ageing in place generally assumes that there is a particular quality to environments or standard of liveability in which people successfully age in place. The aim of this thesis was to examine if there are particular environmental qualities or aspects of liveability that test optimality and to better understand the key liveability factors that contribute to successful ageing in place. Method A strength of this thesis is that it draws on two separate studies to address the research question of what makes high density liveable for older people. In Chapter 3, the two methods are identified and differentiated as Method 1 (used in Paper 1) and Method 2 (used in Papers 2, 3, 4 and 5). Method 1 involved qualitative interviews with 24 inner city high density Brisbane residents. The major strength of this thesis is the innovative methodology outlined in the thesis as Method 2. Method 2 involved a case study approach employing qualitative and quantitative methods. Qualitative data was collected using semi-structured, in-depth interviews and time-use diaries completed by participants during the week of tracking. The quantitative data was gathered using Global Positioning Systems for tracking and Geographical Information Systems for mapping and analysis of participants’ activities. The combination of quantitative and qualitative analysis captured both participants’ subjective perceptions of their neighbourhoods and their patterns of movement. This enhanced understanding of how neighbourhoods and communities function and of the various liveability dimensions that contribute to active ageing and ageing in place for older people living in high density environments. Both studies’ participants were inner-city high density residents of Brisbane. The study based on Method 1 drew on a wider age demographic than the study based on Method 2. Findings The five papers presented in this thesis by publication indicate a complex inter-relationship of the factors that make a place liveable. The first three papers identify what is comparable and different between the physical and social factors of high density communities/neighbourhoods. The last two papers explore relationships between social engagement and broader community variables such as infrastructure and the physical built environments that are risk or protective factors relevant to community liveability, active ageing and ageing in place in high density. The research highlights the importance of creating and/or maintaining a barrier-free environment and liveable community for ageing adults. Together, the papers promote liveability, social engagement and active ageing in high density neighbourhoods by identifying factors that constitute liveability and strategies that foster active ageing and ageing in place, social connections and well-being. Recommendations There is a strong need to offer more support for active ageing and ageing in place. While the data analyses of this research provide insight into the lived experience of high density residents, further research is warranted. Further qualitative and quantitative research is needed to explore in more depth, the urban experience and opinions of older people living in urban environments. In particular, more empirical research and theory-building is needed in order to expand understanding of the particular environmental qualities that enable successful ageing in place in our cities and to guide efforts aimed at meeting this objective. The results suggest that encouraging the presence of more inner city retail outlets, particularly services that are utilised frequently in people’s daily lives such as supermarkets, medical services and pharmacies, would potentially help ensure residents fully engage in their local community. The connectivity of streets, footpaths and their role in facilitating the reaching of destinations are well understood as an important dimension of liveability. To encourage uptake of sustainable transport, the built environment must provide easy, accessible connections between buildings, walkways, cycle paths and public transport nodes. Wider streets, given that they take more time to cross than narrow streets, tend to .compromise safety - especially for older people. Similarly, the width of footpaths, the level of buffering, the presence of trees, lighting, seating and design of and distance between pedestrian crossings significantly affects the pedestrian experience for older people and impacts upon their choice of transportation. High density neighbourhoods also require greater levels of street fixtures and furniture for everyday life to make places more useable and comfortable for regular use. The importance of making the public realm useful and habitable for older people cannot be over-emphasised. Originality/value While older people are attracted to high density settings, there has been little empirical evidence linking liveability satisfaction with older people’s use of urban neighbourhoods. The current study examined the relationships between community/neighbourhood liveability, place and ageing to better understand the implications for those adults who age in place. The five papers presented in this thesis add to the understanding of what high density liveable age-friendly communities/ neighbourhoods are and what makes them so for older Australians. Neighbourhood liveability for older people is about being able to age in place and remain active. Issues of ageing in Australia and other areas of the developed world will become more critical in the coming decades. Creating livable communities for all ages calls for partnerships across all levels of government agencies and among different sectors within communities. The increasing percentage of older people in the community will have increasing political influence and it will be a foolish government who ignores the needs of an older society.

Towards a better understanding of fashion clothing involvement

This study is concerned with consumer involvement in fashion clothing. Amidst the consumer objects that facilitate everyday life, fashion clothing is an important and meaningful object for many consumers. In the extant consumer literature few studies have attempted to examine fashion clothing involvement, particularly in terms of its causes and outcomes. This study then focuses on building a reliable nomological network to bring a greater understanding to this facet of consumer behaviour. To achieve this, materialism and gender are examined as drivers of fashionclothinginvolvement. Recreational shopper identity, ongoing information search, market mavenism, and purchase decision involvement are explored as outcomes of fashion clothing involvement. Data were gathered using an Australian Generation Y sample resulting in 200 completed questionnaires. The results support the study’s model and its hypotheses and show that materialism and gender are significant drivers of fashion clothing involvement. While also, recreational shopper identity, ongoing information search, market mavenism and purchase decision involvement are significant outcomes of fashion clothing involvement.

The Empty City (playreading)

This 45 minute non-verbal intermedial performance for children was adapted from the picture book I authored of the same name. The process involved writing and re-writing text and music with the result being a new draft of both script and soundtrack. Part of the judging process for the award the script was nominated for involved a playreading, which offered a particular challenge to the researcher in terms of composition and playwriting. How can a script and soundtrack for a non-verbal, intermedial work adapt and innovate the within the formal and practical constraints of the traditional ‘playreading’? This project’s emphasis on nestling intermediality within ostensibly traditional theatrical constraints and processes draws on concepts of musicalisation, identified by Varopolou. (in Lehmann 2006:91) Certain ‘musical moments’ in the piece echoed Ross Brown’s (2010) acoustemological concepts of sonification of everyday life, and the process involved dynamic curation of ‘music under’ for emotional effect, avoiding cinematic clichés and reaching for connections between music and emotion characterized by scholars such as Juslin and Sloboda (2001) The resulting performance was a hybrid of playreading and slideshow, supported by an original soundtrack of ‘music under’ (pre-recorded, but ‘DJ’ed’ live) as well as text-driven moments where music and sound were foregrounded. Research contribution This iteration of The Empty City shows that the tradition of the playreading can be a playful space where even the multiple layers of an intermedial performance text can be represented. The Empty City was a finalist in the 2012-13 Queensland Premier’s Drama Award. A ticketed public playreading of the script was held in the Queensland Theatre Company’s Bille Brown Studio on the 28th of July 2012 alongside the other finalists.

Using scenarios to explore the social aspects of design led innovations

Emerging technologies have redefined the way people go about everyday life. An increasing array of online and on-the-go solutions supporting remote work, entertainment on demand, information sharing, social communication, telehealth and beyond, are now available at the touch of a screen. This paper discusses concept of scenarios as a design tool that can be successfully employed by organisations as an innovative design led approach to: (i) understand people’s everyday practices in current social contexts in order to identify opportunities and emerging markets, and (ii) reveal stakeholder relationships existing in the provision of services within current everyday practices. To illustrate this approach, two case studies will be presented: the first focusing on a real industry project exploring opportunities for the development of future health care services, the second focusing on people’s access to services as part of a transport journey experience. This paper aims to demonstrate the use of scenarios as part of a design led innovation approach to understand the social aspects and their complexities of new designs in an increasing everyday technological driven context.