Associations between dietary iron and zinc intakes, and between biochemical iron and zinc status in women

Iron and zinc are found in similar foods and absorption of both may be affected by food compounds, thus biochemical iron and zinc status may be related. This cross-sectional study aimed to: (1) describe dietary intakes and biochemical status of iron and zinc; (2) investigate associations between dietary iron and zinc intakes; and (3) investigate associations between biochemical iron and zinc status in a sample of premenopausal women aged 18–50 years who were recruited in Melbourne and Sydney, Australia. Usual dietary intakes were assessed using a 154-item food frequency questionnaire (n = 379). Iron status was assessed using serum ferritin and hemoglobin, zinc status using serum zinc (standardized to 08:00 collection), and presence of infection/inflammation using C-reactive protein (n = 326). Associations were explored using multiple regression and logistic regression. Mean (SD) iron and zinc intakes were 10.5 (3.5) mg/day and 9.3 (3.8) mg/day, respectively. Median (interquartile range) serum ferritin was 22 (12–38) μg/L and mean serum zinc concentrations (SD) were 12.6 (1.7) μmol/L in fasting samples and 11.8 (2.0) μmol/L in nonfasting samples. For each 1 mg/day increase in dietary iron intake, zinc intake increased by 0.4 mg/day. Each 1 μmol/L increase in serum zinc corresponded to a 6% increase in serum ferritin, however women with low serum zinc concentration (AM fasting < 10.7 μmol/L; AM nonfasting < 10.1 μmol/L) were not at increased risk of depleted iron stores (serum ferritin <15 μg/L; p = 0.340). Positive associations were observed between dietary iron and zinc intakes, and between iron and zinc status, however interpreting serum ferritin concentrations was not a useful proxy for estimating the likelihood of low serum zinc concentrations and women with depleted iron stores were not at increased risk of impaired zinc status in this cohort.

The films of John Hughes: a history of independent screen production in Australia

ABSTRACTIn The Films of John Hughes: A history of independent screen production in Australia filmmaker and academic John Cumming tells the ongoing story of Hughes’ work illustrating the delicate balance of individual, collective and corporate agendas that many contemporary artists need to negotiate. This story begins in the 1960s with a generation of intelligent, socially engaged young people who challenge established power structures, conventions and stereotypes in art, politics and the media. Experiments were being made with grassroots democracy, with new social formations and new ways of seeing and communicating. The book also pays attention to earlier periods of cultural and political activism that captured Hughes’ imagination in the 1970s and became the subject of a number of his films over a period of nearly forty years. Through these films Cumming traces the outline of post-war film culture and production in Melbourne from the 1940s and sets this history within the context of international trends in independent filmmaking throughout the 20th Century and into the 21st.The work of an independent filmmaker has always included a great deal more than directing films. Working in an artisanal mode, he or she often performs, or has a hand in, every aspect of craft at the same time as engaging in discussion and organisation around the wider sphere of screen culture and industry. In addition to having proficiency as a producer, photographer, sound recordist, editor, distributor and exhibitor of films, there is research, organisation, lobbying, entrepreneurship and mentoring to be done. As an independent producer-director, John Hughes has engaged in all of these activities – often simultaneously. He is also a scholar, writer, organiser, activist and teacher. As a television bureaucrat he was both eminent and innovative, and through his filmmaking he has become a leading historian of Australian documentary cinema. ‘… that view – that art and politics are inherently at odds – is still lurking around. It is at the heart of cultural conservatism; and John Hughes’s film-making, from the 1970s to the present, confounds its proponents. His cinema is at once crowded, detailed, elegant and absolutely lucid; at the same time, it is shot through with political and historical understandings.’ Sylvia Lawson, ‘Such a Bloody Wonderful Place’, Inside Story, 28 April 2013.

Failures in communication through documents and documentation across the perioperative pathway.

AIMS AND OBJECTIVES: To explore how communication failures occur in documents and documentations across the perioperative pathway in nurses' interactions with other nurses, surgeons and anaesthetists. BACKGROUND: Documents and documentation are used to communicate vital patient and procedural information among nurses, and in nurses' interactions with surgeons and anaesthetists, across the perioperative pathway. Previous research indicates that communication failure regularly occurs in the perioperative setting. DESIGN: A qualitative study was undertaken. METHODS: The study was conducted over three hospitals in Melbourne, Australia. One hundred and twenty-five healthcare professionals from the disciplines of surgery, anaesthesia and nursing participated in the study. Data collection commenced in January 2010 and concluded in October 2010. Data were generated through 350 hours of observation, two focus groups and 20 semi-structured interviews. A detailed thematic analysis was undertaken. RESULTS: Communication failure occurred owing to a reliance on documents and documentation to transfer information at patient transition points, poor quality documents and documentation, and problematic access to information. Institutional ruling practices of professional practice, efficiency and productivity, and fiscal constraint dominated the coordination of nurses', surgeons' and anaesthetists' communication through documents and documentation. These governing practices configured communication to be incongruous with reliably meeting safety and quality objectives. CONCLUSIONS: Communication failure occurred because important information was sometimes buried in documents, insufficient, inaccurate, out-of-date or not verbally reinforced. Furthermore, busy nurses were not always able to access information they required in a timely manner. Patient safety was affected, which led to delays in treatment and at times inadequate care. RELEVANCE TO CLINICAL PRACTICE: Organisational support needs to be provided to nurses, surgeons and anaesthetists so they have sufficient time to complete, locate, and read documents and documentation. Infrastructure supporting communication technologies should be implemented to enable the rapid retrieval, entry, and dispersion of information.

Patient participation in pulmonary interventions to reduce postoperative pulmonary complications following cardiac surgery.

BACKGROUND: Clinical interventions aimed at reducing the incidence of postoperative pulmonary complications necessitate patient engagement and participation in care. Patients' ability and willingness to participate in care to reduce postoperative complications is unclear. Further, nurses' facilitation of patient participation in pulmonary interventions has not been explored. OBJECTIVE: To explore patients' ability and willingness to participate in pulmonary interventions and nurses' facilitation of pulmonary interventions. DESIGN: Single institution, case study design. Multiple methods of data collection were used including preadmission (n=130) and pre-discharge (n=98) patient interviews, naturalistic observations (n=48) and nursing focus group interviews (n=2). SETTING: A cardiac surgical ward of a major metropolitan, tertiary referral hospital in Melbourne, Australia. PARTICIPANTS: One hundred and thirty patients admitted for cardiac surgery via the preadmission clinic during a 1-year period and 40 registered nurses who were part of the permanent workforce on the cardiac surgical ward. OUTCOME MEASURES: Patients' understanding of their role in pulmonary interventions and patients' preference for and reported involvement in pulmonary management. Nurses' facilitation of patients to participate in pulmonary interventions. RESULTS: Patients displayed a greater understanding of their role in pulmonary interventions after their surgical admission than they did at preadmission. While 55% of patients preferred to make decisions about deep breathing and coughing exercises, three-quarters of patients (75%) reported they made decisions about deep breathing and coughing during their surgical admission. Nurses missed opportunities to engage patients in this aspect of pulmonary management. CONCLUSIONS: Patients appear willing to take responsibility for pulmonary management in the postoperative period. Nurses could enhance patient participation in pulmonary interventions by ensuring adequate information and education is provided. Facilitation of patients' participation in their recovery is a fundamental aspect of care delivery in this context.

The future of the past: digital media in Holocaust museums

This essay critically examines the implications of digital media for the remembrance of the Holocaust in contemporary museum spaces, a development that has seen fundamental shifts in thinking around agency, education and entertainment. Expanding existing discussions of this issue into the Australian context, the essay takes as its central case study the design and integration of interactive StoryPod screen media in Melbourne’s Jewish Holocaust Centre. Addressing both the limitations and potentialities of interactive digital technologies for facilitating visitor-viewers’ engagement with survivor stories, the analysis highlights that digital media can be used to complement and enhance – rather than replace – traditional artefact and photographic displays, and will play an integral role in the Holocaust museums of the future.

Changes, challenges, and successes facing secondary pre-service teacher education in Australia

In December 2008, the Australian Government was presented with a report from a Review of Australian HigherEducation known as the ‘Bradley Review’. The report clearly articulates many challenges that lie ahead; it questions thestructure, organisation and financial position of Australia to effectively compete in the global economy. This paperprovides a succinct discussion of some of the challenges and dilemmas encountered at a metropolitan Australianuniversity in Melbourne within the Faculty of Arts and Education in the School of Education. The courses will bereaccredited in 2016 and has to comply with the new Australian Qualification Framework (AQF), the AustralianTeaching Standards Framework (AITSL) and the Victorian Institute of Teaching (VIT). By employing narrative inquiry,reflective practice and document analysis as methodology, I discuss the Bachelor of Teaching (Secondary)/Bachelor ofArts course (degree), the largest secondary pre-service teacher education course at a university in Melbourne presentingsome strategies and inviting international dialogue in relation to some of the challenges faced regarding increasednumbers of students and lower entrance scores. Limitations of the current course are acknowledged and generalizationscannot be made to other education courses at universities across Australia. However, some new initiatives in the facultyare offered.

Reducing children's classroom sitting time using sit-to-stand desks: findings from pilot studies in UK and Australian primary schools.

BACKGROUND: This research examined the influence of sit-to-stand desks on classroom sitting time in primary school children. METHODS: Pilot controlled trials with similar intervention strategies were conducted in primary schools in Melbourne, Australia, and Bradford, UK. Sit-to-stand desks replaced all standard desks in the Australian intervention classroom. Six sit-to-stand desks replaced a bank of standard desks in the UK intervention classroom. Children were exposed to the sit-to-stand desks for 9-10 weeks. Control classrooms retained their normal seated desks. Classroom sitting time was measured at baseline and follow-up using the activPAL3 inclinometer. RESULTS: Thirty UK and 44 Australian children provided valid activPAL data at baseline and follow-up. The proportion of time spent sitting in class decreased significantly at follow-up in both intervention groups (UK: -9.8 ± 16.5% [-52.4 ± 66.6 min/day]; Australian: -9.4 ± 10% [-43.7 ± 29.9 min/day]). No significant changes in classroom sitting time were observed in the UK control group, while a significant reduction was observed in the Australian control group (-5.9 ± 11.7% [-28.2 ± 28.3 min/day]). CONCLUSIONS: Irrespective of implementation, incorporating sit-to-stand desks into classrooms appears to be an effective way of reducing classroom sitting in this diverse sample of children. Longer term efficacy trials are needed to determine effects on children's health and learning.

Too hot to move? Objectively assessed seasonal changes in Australian children's physical activity

BACKGROUND: Seasonal variations may influence children's physical activity patterns. The aim of this study was to examine how children's objectively-measured physical activity differed across seasons, and whether different seasonal patterns were observed for boys and girls. METHODS: Three hundred and twenty-six children aged 8-11 years from nine primary schools in Melbourne, Australia, participated in the study. Physical activity was measured every 15-s using hip-mounted GT3X+ ActiGraph accelerometers for seven consecutive days in the Winter (n&thinsp;=&thinsp;249), Spring (n&thinsp;=&thinsp;221), Summer (n&thinsp;=&thinsp;174) and Autumn (n&thinsp;=&thinsp;152) school terms. Time spent in moderate (MPA), vigorous (VPA) and moderate- to vigorous-intensity physical activity (MVPA) at each time point was derived using age-specific cut-points. Meteorological data (maximum temperature, precipitation, daylight hours) were obtained daily during each season. Longitudinal data were analysed using multilevel analyses, adjusted for age, sex, accelerometer wear time, number of valid days, and meteorological variables. RESULTS: Compared to Winter, children engaged in significantly less MPA (-5.0 min) and MVPA (-7.8 min) in Summer. Girls engaged in less MVPA in Spring (-18 min) and Summer (-9.2 min) and more MVPA in Autumn (9.9 min) compared to Winter. Significant changes in MPA and VPA bout frequency and duration were also observed. Significant decreases in VPA bout frequency (3.4 bouts) and duration (2.6 min) were observed for girls in Spring compared to Winter. No significant seasonal changes were observed for boys for all intensities and physical activity accumulation. CONCLUSIONS: Physical activity decreased in Summer compared to Winter, contrasting previous research that typically reports that children are most active in summer. Greater fluctuations were observed for girls' activity levels. In addition, girls' activity duration and bouts appeared to be more susceptible to seasonal changes compared to boys. The results suggest that strategies to promote physical activity may be needed in Australia during the hot summer months, particularly for girls.

Exploring the myths of morphine in cancer: views of the general practice population

Abstract
Background: Morphine is widely used in cancer care, and understanding the concerns and perceptions of patients, family and friends is vital to managing pain and distress effectively. The ‘myths of morphine’ have frequently been discussed in medical literature, yet the extent to which such views are held is not clear. This qualitative project explores the perceptions and attitudes of the wider community towards morphine use in cancer care, to understand this ‘mythology’ according to those who in the future may themselves require its use.
Methods: Semi-structured interviews were held with patients presenting to a metropolitan general practice clinic in Melbourne, Australia. A grounded theory framework underpinned the data collection and thematic analysis undertaken.
Results: Interviewees (15) were aged 24 – 81, with a variety of experiences with cancer care and previous morphine use. Interviewees were highly supportive of morphine use in cancer care, with this attitude founded on the perceived severity of cancer pain and the powerful nature of morphine. They described a number of reasons morphine may be used in cancer care: to treat pain, to enable peace and also as a treatment for cancer.
Conclusion: The public view of morphine to emerge from this study is markedly different from that discussed in the myths of morphine. It is viewed as a medication that has the ability to provide peace and control both pain and the course of cancer. The participants in this study described a wish for greater involvement in pain control decisions, perceiving morphine as a facilitator rather than a barrier to good cancer care.

Failures in communication through documents and documentation across the perioperative pathway

Aims and objectives: To explore how communication failures occur in documents and documentations across the perioperative pathway in nurses' interactions with other nurses, surgeons and anaesthetists. Background: Documents and documentation are used to communicate vital patient and procedural information among nurses, and in nurses' interactions with surgeons and anaesthetists, across the perioperative pathway. Previous research indicates that communication failure regularly occurs in the perioperative setting. Design: A qualitative study was undertaken. Methods: The study was conducted over three hospitals in Melbourne, Australia. One hundred and twenty-five healthcare professionals from the disciplines of surgery, anaesthesia and nursing participated in the study. Data collection commenced in January 2010 and concluded in October 2010. Data were generated through 350 hours of observation, two focus groups and 20 semi-structured interviews. A detailed thematic analysis was undertaken. Results: Communication failure occurred owing to a reliance on documents and documentation to transfer information at patient transition points, poor quality documents and documentation, and problematic access to information. Institutional ruling practices of professional practice, efficiency and productivity, and fiscal constraint dominated the coordination of nurses', surgeons' and anaesthetists' communication through documents and documentation. These governing practices configured communication to be incongruous with reliably meeting safety and quality objectives. Conclusions: Communication failure occurred because important information was sometimes buried in documents, insufficient, inaccurate, out-of-date or not verbally reinforced. Furthermore, busy nurses were not always able to access information they required in a timely manner. Patient safety was affected, which led to delays in treatment and at times inadequate care. Relevance to clinical practice: Organisational support needs to be provided to nurses, surgeons and anaesthetists so they have sufficient time to complete, locate, and read documents and documentation. Infrastructure supporting communication technologies should be implemented to enable the rapid retrieval, entry, and dispersion of information.

Keeping connected: the lives of young people with ongoing health conditions in Australia

This chapter draws from a three year longitudinal Australian Research Council (ARC) project conducted in Victoria, Australia with 31 young people who were living with ongoing health conditions. The aim of the Keeping Connected project was to elicit the young people’s views of schooling, their relationships with peers and teachers, and their altered educational opportunities, given their ongoing and widely varying health conditions. Elsewhere in the literature these young people are often described as living with chronic illness (Hopkins et al., 2013; Moss, 2012). Victoria, Australia, is home to more than 1.2 million children and young people, representing just under 25% of the national child population. The Royal Children’s Hospital Education Institute (RCHEI), one of the sponsoring research partners for this study is located in Melbourne, the capital city of Victoria. The study makes a unique contribution to our knowledge of chronic illness, or what we prefer to refer to as ongoing health conditions, which affect 12% of school age students in Australia. One of my ongoing observations is that not all research that is produced in the name of social justice or analysing exclusions in schooling is approached through the repositioning of the qualitative research which has occurred over the past two decades. Throughout this chapter I aim to demonstrate how a post qualitative approach can produce a secondary analysis of data once a large scale project is completed. Data can be reworked and represented through networks of the social world, in this case the networks of living with an ongoing health condition as a young person in Australia at the end of the first decade of the twentieth first century.

Teeth Tales: a community-based child oral health promotion trial with migrant families in Australia

OBJECTIVES: The Teeth Tales trial aimed to establish a model for child oral health promotion for culturally diverse communities in Australia. DESIGN: An exploratory trial implementing a community-based child oral health promotion intervention for Australian families from migrant backgrounds. Mixed method, longitudinal evaluation. SETTING: The intervention was based in Moreland, a culturally diverse locality in Melbourne, Australia. PARTICIPANTS: Families with 1-4-year-old children, self-identified as being from Iraqi, Lebanese or Pakistani backgrounds residing in Melbourne. Participants residing close to the intervention site were allocated to intervention. INTERVENTION: The intervention was conducted over 5 months and comprised community oral health education sessions led by peer educators and follow-up health messages. OUTCOME MEASURES: This paper reports on the intervention impacts, process evaluation and descriptive analysis of health, knowledge and behavioural changes 18 months after baseline data collection. RESULTS: Significant differences in the Debris Index (OR=0.44 (0.22 to 0.88)) and the Modified Gingival Index (OR=0.34 (0.19 to 0.61)) indicated increased tooth brushing and/or improved toothbrushing technique in the intervention group. An increased proportion of intervention parents, compared to those in the comparison group reported that they had been shown how to brush their child's teeth (OR=2.65 (1.49 to 4.69)). Process evaluation results highlighted the problems with recruitment and retention of the study sample (275 complete case families). The child dental screening encouraged involvement in the study, as did linking attendance with other community/cultural activities. CONCLUSIONS: The Teeth Tales intervention was promising in terms of improving oral hygiene and parent knowledge of tooth brushing technique. Adaptations to delivery of the intervention are required to increase uptake and likely impact. A future cluster randomised controlled trial would provide strongest evidence of effectiveness if appropriate to the community, cultural and economic context. TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry (ACTRN12611000532909).

The Greek diaspora of Melbourne: Australia through the eyes of the second generation Greek Australian

form in the 1950s with migration to Australia in the years following the Second World War and the Greek Civil War. The elders of this community, in particular, have tried to ensure that their culture and traditions are kept alive and are handed down from generation to generation. The long history and cultural richness of the Greek tradition is a great source of pride to its members, and this is a key characteristic of the Greek community of Australia. Young and old Greek Australians speak of their country of origin with great pride and passion, as it remains central to their perception of nationality and ethnicity. This importance placed on the retention of the language and culture of their nation of origin means that cultural transmission across generations is of great significance to the community and can provide valuable insight into their interpretation of their own experiences. This paper will present findings from a three generation study about health beliefs and practices of women in the Melbourne Greek community. The experience of granddaughters, who represent the second Australian generation, and how they see their grandmothers’ experience as migrants to Australia will be discussed. The impact of the Diaspora phenomenon and the creation of a Greek community in Melbourne will be considered in the context of health, memory, religion, Greek culture, food, and personal and group identity.

Examining the perception of tenants in sustainable office buildings

Purpose – The purpose of this paper is to address two major challenges faced by sustainable building owners: first, address the gap between an occupant’s expectations of sustainable building outcomes and what the building actually provides and second, overcome the lack of user knowledge about sustainability design and operation for a particular with regards to performance. Design/methodology/approach – This study used a focus group approach to investigate the gap between: user expectations and sustainable building performance. The study surveyed occupants of sustainable office buildings in Melbourne, Australia. Findings – There is no significant relationship between users’ expectations and users’ experience of sustainable building performance and users’ knowledge about sustainability and the building they were worked in. Research limitations/implications – The research was limited to sustainable office buildings. New office buildings seeking to incorporate sustainability which need to focus on the needs of tenants in order to maximise value. Practical implications – There is an urgent need to ensure sustainable office buildings meet the needs of present and future occupiers without compromising short and long-term occupier satisfaction levels with regards to sustainability and operation of the building. Social implications – Increasing the level of sustainability in office buildings has been a major trend over the past decade however the tenants need to be consulted in the post-occupancy phase. Originality/value – Little attention has been given in the property management literature to sustainable office buildings and value drivers. This is an original and innovative study, partly due to the recent developments in sustainable buildings.

The interior of our memories: a history of Melbourne's Jewish holocaust centre

The Interior of Our Memories describes the development of the Centre within global Holocaust memorial activity, both during the Holocaust and in the following decades when many survivors made new lives for themselves in Melbourne. The story begins, not in March 1984 when it first opened its doors, but during the Holocaust, when survivors began gathering documents. The book provides a history of the Centre’s early days and examines its transformation from a collection of photos, documents and material objects into the modern, educationally focused organisation it is today. The book situates the Jewish Holocaust Centre within a broader context, exploring issues of memory, testimony, the role of the museum within contemporary society, and what we can learn from one of the worst tragedies in human history.