Residential proximity to school and the active travel choices of parents

Issue addressed: Walking for transport can contribute significantly to health-enhancing physical activity. We examined the prevalence and duration of walking to and from school, together with perceived influences on doing so, among parents of primary school children. Methods: Questionnaires were completed by parents from four primary schools (one government and three private) located in south-east Queensland (n=559; 40% response rate). Results: Eighteen per cent of parents reported walking for at least 10 minutes during journeys to school. Significantly greater proportions of parents with only one car in their household, with a child who attended a government school, with no driver’s licence, who had less than 11 years of education, and lived within two kilometres of the school walked for at least 10 minutes during the school journey. Factors perceived by parents most strongly to influence walking to school were: being physically active; safety concerns for the child walking alone; not having to park; walking being the child’s preferred option; too much motor vehicle traffic; and their child’s age and level of road sense. Conclusions: Despite the overall low prevalence of walking to school by parents, health-enhancing benefits may be achieved even when other modes of transport are used in conjunction with walking.

Treatment of depression in low-level residential care facilities for the elderly

Background: The rate of recognition and treatment of depressed older people in nursing homes is low. Data from the low-level residential care population have not been reported. This study aimed to collect information about the treatment of depression among older persons living in low-level residential care (hostels).

Method: The participants comprised 300 elderly residents from ten low-level residential care facilities from various suburbs in metropolitan Melbourne. The participants were interviewed by a trained clinical psychologist to determine the presence or absence of major or minor depressive disorder using the Structured Clinical Interview for DSM-IV Axis I Disorder (SCID-I). Each participant was also administered the Standardized Mini-mental State Examination (SMMSE) to determine level of cognitive function. The clinical psychologist then reviewed all cases in consultation with a geropsychiatrist experienced in the diagnosis of depression among older people, prior to assigning a diagnosis of depression.

Results: An important finding in this study was the low treatment for currently depressed residents, with less than half of those in the sample who were depressed receiving treatment. However, 61 of the 96 residents out of the sample of 300 who were on antidepressants were not currently depressed.

Conclusion: There is an under recognition and under treatment of currently depressed older people in low-level residential care facilities (hostels) just as has been reported in studies in nursing homes. However, there are high numbers receiving antidepressants who are not currently depressed.

Anthropometric and biochemical markers for nutritional risk among residents within an Australian residential care facility

The risk of malnutrition is high among elderly population, yet few studies have measured indicators of nutritional status among Australian aged-care residents. To determine the relationship between nutritional status and bone density, hand grip strength, and the timed-up and go test, in a group of Australian aged-care residents. Anthropometric and biochemical analysis measured in subjects recruited to be part of a six month multivitamin supplementation study. One hundred and fifteen subjects participated (68% female). The mean (SD) age and body weight was 80.2(10.6) years, and 66.5(15.0) kg, respectively. Eleven percent were underweight (body mass index, BMI, <or =20.0 kg/m(2)), and 20% were obese BMI >or =30 kg/m(2)). Low serum 25-hydroxy-vitamin D (25(OH)D, <or =50 nmol/L) concentrations were found among 79% of subjects. After adjustment for body weight, there was an association between serum 25(OH)D and bone density (heel ultrasound) (r=.204, p=.027). Low serum zinc <or =10.7 micromol/L) concentrations were found among 46% of subjects; this group had a slower timed up and go time compared with those with higher zinc concentrations (n=19, 44.6 +/- 5.6 seconds vs. n=27, 30.0 +/- 3.3 seconds, p=.020). There were no associations between nutritional markers and hand grip strength. In this group, more than (3/4) of subjects had low serum 25(OH)D, and 46% had low zinc concentrations. Serum 25(OH)D was associated a lower bone density and zinc with a slower walking time. This indicates that the elderly in long term residential care facilities are at high risk for poor nutritional status, potentially increasing morbidity and mortality.

Serum vitamin D and falls in older women in residential care in Australia

Objectives: To determine the prevalence of vitamin D deficiency in older people in residential care and the influence that the level of vitamin D may have on their incidence of falls.

Design: Prospective cohort.

Setting: Residential care facilities for older people in several states of Australia.

Participants: Six hundred sixty-seven women in low-level care and 952 women in high-level care, mean age 83.7 years.

Measurements: Serum 25-hydroxyvitamin D (25D) levels and recognized risk factors for falls including current medication use, a history of previous fractures, weight, tibial length (as a surrogate for height), cognitive function, walking ability, and frequency of going outdoors were determined. The women in low-level care and high-level care were followed for an average of 145 and 168 days, respectively. Falls were recorded prospectively in diaries completed monthly by residential care staff.

Results: Vitamin D deficiency (defined as a serum 25D level below 25 nmol/L) was present in 144 (22%) women in low-level care and 428 (45%) in high-level care. After excluding 358 bed-bound residents and adjusting for weight, cognitive status, psychotropic drug use, previous Colles fracture, and the presence of wandering behavior, log serum 25D level remained independently associated with time to first fall. The adjusted hazards ratio was 0.74 (95% confidence interval=0.59–0.94; P=.01), implying a 20% reduction in the risk of falling with a doubling of the vitamin D level.

Conclusion: Vitamin D deficiency is common in residential care in Australia. A low level of serum vitamin D is an independent predictor of incident falls.

Perceived environment attributes, residential locaction, and walking for particular purposes

Background
Identifying environmental factors that can influence physical activity is a public health priority. We examined associations of perceived environmental attributes with walking for four different purposes: general neighborhood walking, walking for exercise, walking for pleasure, and walking to get to and from places.

Methods
Participants (n =399; 57% women) were surveyed by mail. They reported place of residence, walking behaviors, and perceptions of neighborhood environmental attributes.

Results
Men with the most positive perceptions of neighborhood “aesthetics” were significantly more likely (odds ratio [OR]=7.4) to be in the highest category of neighborhood walking. Men who perceived the weather as not inhibiting their walking were much more likely (OR=4.7) to be high exercise walkers. Women who perceived the weather as not inhibiting their walking were significantly more likely to be high neighborhood walkers (OR=3.8) and those with moderate perceptions of “accessibility” were much more likely to do more walking for pleasure (OR=3.5).

Conclusions
Different environmental attributes were associated with different types of walking and these differed between men and women. Approaches to increasing physical activity might usefully focus on those attributes of the local environment that might influence particular subsets of walking behavior.

How residential environments impact on health

This article describes the findings of a research study that investigated the factors (including access to nature such as parks, gardens and bodies of water) impacting on inner city high-rise residents’ health and wellbeing. The findings revealed that a range of factors impact on residents’ health and wellbeing, either directly or indirectly and suggest implications for health and community service professionals, housing management officials, park and open space managers and urban designers/planners.

Unresolved legal issues pertaining to the native residential school

“The research paper considers the legal issues arising from the Canadian Native Residential Schools and the Australian ‘stolen generation’. The paper compares and contrasts the approaches taken by the respective courts and governments in these Nations to the various causes of actions stemming from such. Building on this, the paper will focus on the legal issues that are yet to be considered by the courts including breaches of domestic and international treaties, liability for loss of culture and language intergenerational claims.”

Nutrient intake and plate waste from an Australian residential care facility

Objective: To determine the plate waste, energy and selected-nutrient intake, from elderly residents living in a high-level care (HLC) and low-level care (LLC) facility.

Design: Three, single, whole day assessments of plate waste, energy, and selected nutrients, using a visual rating plate waste scale.

Setting: Long-term residential care establishment.

Subjects: One hundred and sixty-nine (93 HLC and 76 LLC) individual daily intakes.

Main findings: The mean energy wasted throughout the whole day was 17%. The energy wasted from main meals (16%) was significantly less than the energy wasted at mid-meals (22%, P=0.049). The lowest mean energy wastage occurred at breakfast (8%) compared to lunch (22%) and dinner (25%, P<0.001). The mean (s.d.) daily energy served and consumed was 8.1 (2.0) and 6.6 (2.2) MJ, respectively. There was no difference in energy served or consumed between HLC and LLC residents. On the observation day, 60% of residents consumed less than their estimated energy requirement. The mean calcium intake was 796 (346) mg, and the median (inter-quartile range) vitamin D intake was 1.78 (2.05) μg.

Conclusion: On 1 day, more than half the residents surveyed were at risk of consuming an inadequate energy intake, which over-time, may result in body weight loss. Although wastage was not excessive and energy served was adequate, the amount of food eaten was insufficient to meet energy and calcium requirements for a significant number of residents and it is not possible to consume sufficient vitamin D through food sources.