Impact of medication reconciliation and review on clinical outcomes

To examine the evidence regarding the effectiveness of medication reconciliation and review and to improve clinical outcomes in hospitals, the community, and aged care facilities.

Knowledge, attitudes, and self care practices associated with age related eye disease in Australia

AIM: To determine the level of correct knowledge about common eye disease and attitudes towards blindness prevention and treatment, and how these factors influence self care practices in a population based sample. METHODS: A cluster random sample of the Victorian population was interviewed. The study population comprised residents aged 40 years of age or older living in five randomly selected Melbourne metropolitan suburbs and four randomly selected rural areas of Victoria. Questions were asked to ascertain each person's knowledge of common age related eye disease--that is, cataract, age related macular degeneration (AMD), and glaucoma. A subsample of the population was also asked questions to determine their attitudes to blindness prevention and treatment. All respondents were asked the year of their last visit to an eye practitioner. RESULTS: A total of 3184 (89%) eligible residents were assessed. Sex (females), age (younger people), higher levels of education (secondary, trade, or tertiary education), recent visit to an eye practitioner (within the past 2 years) and English spoken at home appeared to be significant predictors of knowledge of common age related eye conditions. Younger people believed blindness prevention and blindness treatment were the highest priorities compared with other diseases; people who spoke English at home and people with knowledge of common age related eye disease also considered blindness treatment to be the highest priority compared with other diseases. People with a previous diagnosis of age related eye disease, older people, females, people with correct knowledge of common eye diseases, and those who spoke English at home were significantly more likely to be under eye care. No interaction was found between knowledge and positive attitudes to self care practices. CONCLUSION: These data show that there is a large gap in the public's knowledge and understanding of eye disease that will need to be understood for eye health promotion activities.

Addressing healthy lifestyle behaviours amongst young people in out-of-home care

The aim of this thesis was to develop a program of research that evaluated enablers, barriers and pathways for establishing healthy lifestyle behaviours among young people living in residential out-of-home care. This included development of the Healthy Eating, Active Living (HEAL) intervention, and was the first program, nationally and internationally to evaluate a healthy lifestyle intervention in this setting.

Justice, community, and dialogue in international relations

This book is concerned with the issue of cultural diversity and international morality. The author asks whether cultural diversity presents an obstacle to the development of ethical codes which could be acceptable to cultures around the world. He argues that the human capacity to engage in conversation and the ability to understand each other despite linguistic and cultural differences can provide the basis for the development of a world-wide, cosmopolitan moral community. Conversation can be a moral act, in which participants treat each other as equals despite their differences.

Rural nursing and health care reforms : building a social model

This article explores recent shifts in health-care policy and the implications for rural nursing in Australia. Health-care reforms have resulted in the implementation of a 'market forces' ideology, creating tensions between economic imperatives and the need for equity and greater access in rural service delivery. New models of health-service delivery have been developed that have significant implications for the way rural health care is defined, practised and received. The issues surrounding the context of rural nursing practice and service delivery are discussed.

Development, implementation, and evaluation of a continence education package in acute and subacute care settings

OBJECTIVE: The objective of the study was to trial and evaluate the effect that a discharge Continence Education Package (CEP) had on patients' continence awareness and management preferences.
DESIGN: An exploratory descriptive design was used.
SETTINGS AND SUBJECTS: A total of 631 participants were included in the study: 352 females (55.8%) and 279 males (44.2%) from 4 rural and regional settings in Victoria, Australia.
INSTRUMENTS AND METHODS: A specifically designed questionnaire was used to assess participants' knowledge of incontinence and its management and also to investigate their treatment preferences and intentions if they experienced this type of problem. Data were collected at 2 time periods. Specifically, patients were interviewed before discharge from acute and subacute settings identified as Time 1 (T1). Then the participants were given the CEP and asked to complete a similar questionnaire.
RESULTS: The findings revealed that fewer than 25% of participants had received information on continence before the study being conducted, yet the majority had indicated that they had experienced continence symptoms. The majority of participants found the CEP easy to understand (98.2%) and helpful (95.3%). Most participants said it provided them with information about types of actions to take and/or treatment options for incontinence problems. It also raised their awareness of the signs and symptoms associated with incontinence and provided them with a useful self-administered gauge with which to assess their continence status.
CONCLUSIONS: These findings suggest that the CEP may be a useful educational tool for use in the general population.

Fall risk factors and the nature of falls in inpatient oncology and palliative care settings

Using a prospective design, this study examined falls risk factors and the nature of patient falls in oncology and palliative care settings. Two hundred and twenty seven patients admitted to the oncology and palliative care units at a private hospital participated in this study. Of these, 34 patients had a fall and 193 patients did not have a fall. Twenty-four nurses who attended to patients who fell were interviewed. Findings revealed that, when compared to patients who did not fall, fallers had a significantly higher mean age; were assessed as more physically dependent using the Eastern Cooperative Oncology Group scale; were less alert and more confused; were more likely to have responded incorrectly to orientation to person, time and place; were weaker pre-fall in arm muscle strength; and were more fatigued. These factors are worthy of further exploration to determine whether they are more sensitive than the currently used falls risk factors used in oncology and palliative care settings.

Individual, social and home environment determinants of change in children's television viewing: the Switch-Play intervention

Understanding potential determinants of change in television (TV) viewing among children may enhance the effectiveness of programs targeting this behaviour. This study aimed to investigate the contribution of individual, social and home environment factors among 10-year-old Australian children to change in TV viewing over a 21-month period. A total of 164 children (49% boys) completed a 19-lesson (9-month) intervention program to reduce TV viewing time. Children completed self-administered surveys four times over 21 months (pre- and post-intervention, 6- and 12-month follow-up). Baseline factors associated with change in TV viewing during the intervention and follow-up periods were: ‘asking parents ≥once/week to switch off the TV and play with them’ (21.6 min/day more than those reporting <once/week, p = 0.007); being able to ‘watch just 1 h of TV per day’ (26.1 min/day less than those who could not, p = 0.010); ‘watching TV no matter what was on’ (36.6 min/day more than those who did not, p < 0.001); and ‘continuing to watch TV after their program was over’ (33.0 min/day more than those who did not, p = 0.006). With every unit increase in baseline frequency of TV viewing with family and friends, children spent on average 4.0 min/day more watching TV over the 21-month period (p = 0.047). Baseline number and placement of TVs at home did not predict change in children's TV viewing over the 21 months. Greater understanding of the family dynamics and circumstances, as well as the individual and social determinants of TV viewing, will be required if we are to develop effective strategies for reducing TV viewing in children.

Knowledge, attitudes and self-care practices related to sun protection among secondary students in Australia

The aim of this research was to ascertain changes in sun-related knowledge, attitudes and self-care practices among Australian secondary school students between 1993 and 1996. Two cross-sectional surveys of sun-related attitudes, beliefs and behavior of young people aged 12–17 years of age, were conducted in 1993 and 1996. Over 80% of adolescents at both time periods knew about the issues related to skin cancer prevention, frequency of burning and burning on cloudy days. Adolescent attitudes had shifted positively in the areas of staying inside in 1996 [relative risk (RR): 1.13; 95% confidence interval (CI): 1.09–1.17] and staying under shade in 1996 (RR: 1.16; 95% CI: 1.13–1.18). Desire for a moderate or dark tan was lower in 1996 (45%) than in 1993 (50%). Respondents reported that they were less likely to wear brief clothing to get a suntan in 1996 (RR: 0.81; 95% CI: 0.78–0.84) and were significantly more likely to stay in the shade in 1996 (RR: 1.19; 95% CI: 1.16–1.23). We conclude that there has been a shift in attitudes towards use of shade and avoidance of unnecessary exposure, and away from use of sunscreens and sunglasses. The results suggest that adolescents may be more ready to accept structural changes that move desired activities out of the sun.

Cecil street studio: improvised community and sustainable practices

It is a little after 7.00pm on a Sunday evening and people are still arriving, slightly hurried as they kick off their shoes before entering the studio. They pay $7.00 and find a seat facing the bare studio floor; white floor against the pink walls. The room seems crowded, although the numbers are not large, and people talk comfortably sitting on the few benches and chairs or on the floor. One of the performers emerges from her conversation amongst the audience to front the group and the babble drops away. “How many of you are new to Conundrum?’ she asks. A few people raise their hands, but many do not. The question is a litmus test for the state of the audience and as a way to bring the novice into the game. “Everything performed here tonight will be completely improvised” she continues. “And tonight on Conundrum we have…” and she rattles off a list of the names of the groups or solo performers who will be performing that evening. Some of the names or groups are different from the last Conundrum one month previously. But two of the groups, State of Flux and 5 Square Metres, have been performing at Conundrum, on the last Sunday of every month, for the last eight years.