Falls and mobility in Parkinson’s disease : protocol for a randomised controlled clinical trial

Background Although physical therapy and falls prevention education are argued to reduce falls and disability in people with idiopathic Parkinson's disease, this has not yet been confirmed with a large scale randomised controlled clinical trial. The study will investigate the effects on falls, mobility and quality of life of (i) movement strategy training combined with falls prevention education, (ii) progressive resistance strength training combined with falls prevention education, (iii) a generic life-skills social program (control group).
Methods/Design People with idiopathic Parkinson's disease who live at home will be recruited and randomly allocated to one of three groups. Each person shall receive therapy in an out-patient setting in groups of 3-4. Each group shall be scheduled to meet once per week for 2 hours for 8 consecutive weeks. All participants will also have a structured 2 hour home practice program for each week during the 8 week intervention phase. Assessments will occur before therapy, after the 8 week therapy program, and at 3 and 12 months after the intervention. A falls calendar will be kept by each participant for 12 months after outpatient therapy. Consistent with the recommendations of the Prevention of Falls Network Europe group, three falls variables will be used as the primary outcome measures: the number of fallers, the number of multiple fallers and the falls rate. In addition to quantifying falls, we shall measure mobility, activity limitations and quality of life as secondary outcomes.
Discussion This study has the potential to determine whether outpatient movement strategy training combined with falls prevention education or progressive resistance strength training combined with falls prevention education are effective for reducing falls and improving mobility and life quality in people with Parkinson's disease who live at home.

Cost effectiveness of preventing falls and improving mobility in people with Parkinson disease : protocol for an economic evaluation alongside a clinical trial

Background Cost of illness studies show that Parkinson disease (PD) is costly for individuals, the healthcare system and society. The costs of PD include both direct and indirect costs associated with falls and related injuries.
Methods This protocol describes a prospective economic analysis conducted alongside a randomised controlled trial (RCT). It evaluates whether physical therapy is more cost effective than usual care from the perspective of the health care system. Cost effectiveness will be evaluated using a three-way comparison of the cost per fall averted and the cost per quality adjusted life year saved across two physical therapy interventions and a control group.
Conclusion This study has the potential to determine whether targetted physical therapy as an adjunct to standard care can be cost effective in reducing falls in people with PD.

Competency-based training, global skills mobility and the teaching of international students in vocational education and training

 In Australia, all vocational education and training (VET) qualifications must be based on competency-based training (CBT) and training packages. Yet, since 2005, there has been a major expansion in the number of VET international students in Australia, 85% of whom are from Asia. Given this development, the teaching and learning contexts in which competency-based training and training packages are located are becoming increasingly diverse and no longer reflect the traditional training characteristics and boundaries that apply for domestic students.
This paper examines the relevance of training packages and CBT for teaching international students in the Australian VET sector. It draws on interviews with teachers and international students from 25 public and private training providers in Australia. The discussion of the findings aims to assist the VET sector create a curriculum framework that supports flexibility, adaptation and responsiveness so that international students’ divergent and shifting study purposes and complex learning characteristics can be catered for effectively. This contributes to helping the sector remain viable in a context in which a VET course is no longer a pathway to migration.

Academic mobility and intercultural encounters

This paper examines the EU-Australia academic mobility as an important contributing aspect of building the Smart, Sustainable and Inclusive European Union.  It focuses on contemporary international encounters and intercultural interactions in academia in the context of an ever growing academic mobility between the EU countries and Australia. The EU–Australia academic mobility is the most visible manifestation of internationalization of education today. Academic mobility is a part of the continuing changes in the teaching and learning processes that academic institutions are undergoing globally. International flows of highly skilled migrants including international students between the EU countries and Australia have been steadily high in the last decades, and research on academic mobility is gaining importance and urgency worldwide. Putting a spotlight on the EU-Australia academic mobility, this paper is interested in identifying optimal conditions and favourable environments for enabling successful intercultural knowledge flows and promoting creative cultures and intercultural connections.

A comparison study of children's independent mobility in England and Australia

We compared independent mobility (freedom to move around the neighbourhood – or similar – without adult accompaniment) among English and Australian schoolchildren. Parents reported mobility licences granted to their children (e.g. allowing them to cross main roads alone) and accompaniment on local trips. Children reported travel mode to school. We examined associations between mobility licences and independent school journeys, and accompaniment on local trips. Among 10–12-year-olds, English children had more licences than Australian children. Mobility licences were directly associated with independent school journeys among primary but not among secondary schoolchildren who travelled further; and inversely associated with parental accompaniment to other destinations. Influences on parental restrictions should be examined to promote children's independent mobility.

Academic mobility, intercultural encounters and cosmopolitan knowledge creation

In this presentation, I examine contemporary international encounters and intercultural interactions in academia as a researcher and recent participant in the ever-expanding global academic mobility programs. Academic mobility is a part of the modern continuing changes in the teaching and learning processes that higher educational institutions are undergoing globally. These changes are often termed ‘internationalization of education’ and they are expressed in the transformations in both the curricula and recruitment practices of students and staff. Global scale of academic mobility opens up prosperous opportunities for intercultural knowledge interchange, knowledge creation, and knowledge enrichment, all leading to the broadening of cultural imagination and creation of shared cosmopolitan cultural meanings.

Intercultural pathways for knowledge Transfer within academic mobility

This paper focuses on academic mobility with the view of examining knowledge flows and effective cultural pathways for knowledge transfer. Its main objective is to set up the theoretical parameters for exploring intercultural encounters within academic mobility with an additional goal of revealing underlining conditions for effective intercultural knowledge transfer and creation. Academic mobility describes global mobilities of tertiary students and university staff and refers to a growing phenomenon worldwide. It creates additional possibilities for exploring the enabling conditions for the intercultural knowledge flows. Academic migrants have been acknowledged as important agents of intercultural knowledge transfer, interchange and, ultimately, knowledge creation. This paper is guided by a hypothesis that cosmopolitan dispositions can create preconditions for successful knowledge transfer in everyday intercultural interactions in academia. In this paper, theoretical notions and ideas are discussed to provide a foundation for designing an ethnographic research which will seek to analyse empirical manifestations of emerging cosmopolitanism. Some preliminary findings of a pilot study are also analysed.

Where do Children Travel to and What Local Opportunities Are Available? The Relationship Between Neighborhood Destinations and Children’s Independent Mobility

Associations between access to local destinations and children’s independent mobility (IM) were examined. In 2007, 10- to 12-year-olds (n = 1,480) and their parents (n = 1,314) completed a survey. Children marked on a map the destinations they walked or cycled to (n = 1,132), and the availability of local destinations was assessed using Geographic Information Systems. More independently mobile children traveled to local destinations than other children. The odds of IM more than halved in both boys and girls whose parents reported living on a busy road (boys, OR = 0.48; girls, OR = 0.36) and in boys who lived near shopping centers (OR = 0.18) or community services (OR = 0.25). Conversely, the odds of IM more than doubled in girls living in neighborhoods with well-connected low-traffic streets (OR = 2.32) and increased in boys with access to local recreational (OR = 1.67) and retail (OR = 1.42) destinations. Creating safe and accessible places and routes may facilitate children’s IM, partly by shaping parent’s and children’s feelings of safety while enhancing their confidence in the child’s ability to use active modes without an adult.