Assumptions of decision-making capacity: the role supporter attitudes play in the realisation of Article 12 for people with severe or profound intellectual disability

The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) was the first legally binding instrument explicitly focused on how human rights apply to people with disability. Amongst their obligations, consistent with the social model of disability, the Convention requires signatory nations to recognise that “…persons with disabilities enjoy legal capacity on an equal basis with others in all aspects of life” and mandates signatory nations to develop “…appropriate measures to provide access by persons with disability to the support they may require in exercising their legal capacity”. The Convention promotes supported decision-making as one such measure. Although Australia ratified the UNCRPD in 2008, it retains an interpretative declaration in relation to Article 12 (2, 3, 4), allowing for the use of substituted decision-making in situations where a person is assessed as having no or limited decision-making capacity. Such an outcome is common for people with severe or profound intellectual disability because the assessments they are subjected to are focused on their cognition and generally fail to take into account the interdependent nature of human decision-making. This paper argues that Australia’s interpretative declaration is not in the spirit of the Convention nor the social model of disability on which it is based. It starts from the premise that the intention of Article 12 is to be inclusive of all signatory nations’ citizens, including those with severe or profound cognitive disability. From this premise, arises a practical need to understand how supported decision-making can be used with this group. Drawing from evidence from an empirical study with five people with severe or profound intellectual disability, this paper provides a rare glimpse on what supported decision-making can look like for people with severe or profound intellectual disability. Additionally, it describes the importance of supporters having positive assumptions of decision-making capacity as a factor affecting supported decision-making. This commentary aims to give a focus for practice and policy efforts for ensuring people with severe or profound cognitive disability receive appropriate support in decision-making, a clear obligation of signatory nations of the UNCRPD. A focus on changing supporter attitudes rather than placing the onus of change on people with disability is consistent with the social model of disability, a key driver of the UNCRPD.

The role of play in teaching English as foreign language in early childhood settings in Indonesia.

This research highlights a teacher’s transformative thinking which has profound implications on how teachers conceptualise child play and learning, thus leads to a way of thinking about English as a foreign language (EFL) could better be supported through the use of play-based pedagogies, especially dramatic play in Indonesian context.

Reverberations after the HIH and other recent Australian corporate collapses: the role of ASIC

This article focuses on some of the litigation and other developments following the recent spate of corporate collapses in Australia. It gives a basic background to abuses of the 1980s, followed by a short description of some of ASIC's statutory powers. The remaining parts of the article focus on the role ASIC played in instituting actions against the directors of some of the collapsed corporations and in particular what ASIC seeks to achieve with high profile litigation. The article concludes that there is no doubt that in the aftermath of these massive corporate collapses ASIC fulfilled its role as the primary Australian corporate regulator with assiduousness. However, it also draws attention to the fact that the challenges for ASIC now will be to play a far more active role in assuring that signs of corporate collapses are detected at the earliest possible juncture. This will probably mean that ASIC's focus will have to be more and more on monitoring companies, rather than on its role as regulator and enforcer in the strict sense of the word.

Birds of remnant vegetation on the Mornington Peninsula, Victoria, Australia: the role of interiors, edges and roadsides

Habitat loss and fragmentation on the Mornington Peninsula, Victoria, Australia, has resulted in a mosaic of forest patches, forest edges abutted by agricultural land and linear habitat strips amidst a human-modified land matrix. To examine the use of forest elements by the avifauna in this landscape, bird populations were sampled along fixed transects established within forest interiors, on forest edges and along forested roadsides. A total of 60 species was recorded during this study, five of which were introduced. Species richness and diversity did not differ significantly between the three habitat elements, but avifaunal composition varied considerably. The species assemblages of all habitat elements differed significantly, with forest interiors and roadsides showing the greatest difference and forest interiors and forest edges showing the least degree of difference. Forest-dependent bird species used both interiors and edges. Interiors differed from edges and roadsides in having lower abundances of open country species, predatory species and introduced species. A clear gradient of change in bird communities from forest interiors to roadside vegetation was observed. This study suggests that the interiors of medium-sized (<1 000 ha) patches may play an important role in conserving bird biodiversity on a local level as they provide refuge for forest-dependent native species in extensively cleared landscapes.

Role of personal factors in women's self-reported weight management behaviour.

The aim of this study was to investigate the role of motivation, anxiety and self-efficacy in self-reported behaviour that may be important for weight loss and weight maintenance. One hundred and twenty-nine females aged 18–81 years were recruited from a variety of social, sporting venues and work places within a local community. Participants completed questionnaires assessing their levels of participation and perseverance in weight management activities, their motivation levels, their anxiety levels (State Anxiety Inventory) and their levels of self-efficacy for weight management behaviours. Motivation was found to play a major role in participation in weight management activities. Anxiety and self-efficacy played no significant role. The findings are discussed in relation to previous studies, and directions for future studies are indicated. It is argued that the level of motivation is a key factor that should be taken into account for each individual engaging in women's weight management programmes, and that further research should be undertaken to identify other relevant factors.

The role of workplace health promotion in addressing job stress

The enormous human and economic costs associated with occupational stress suggest that initiatives designed to prevent and/or reduce employee stress should be high on the agenda of workplace health promotion (WHP) programmes. Although employee stress is often the target of WHP, reviews of job stress interventions suggest that the common approach to combating job stress is to focus on the individual without due consideration of the direct impacts of working conditions on health as well as the effects of working conditions on employees' ability to adopt and sustain ‘healthy’ behaviours. The purpose of the first part of this paper is to highlight the criticisms of the individual approach to job stress and to examine the evidence for developing strategies that combine both individual and organizational-directed interventions (referred to as the comprehensive approach). There is a risk that WHP practitioners may lose sight of the role that they can play in developing and implementing the comprehensive approach, particularly in countries where occupational health and safety authorities are placing much more emphasis on identifying and addressing organizational sources of job stress. The aim of the second part of this paper is therefore to provide a detailed description of what the comprehensive approach to stress prevention/reduction looks like in practice and to examine the means by which WHP can help develop initiatives that address both the sources and the symptoms of job stress.

Home, school, community and their role in the provision of music education

The Department of Education, Science and Training (DEST), is supporting under the Australian Government Quality Outcomes Programme, a National Review of School Music Education. The review, which is intended to submit its report in mid 2005, is interested in investigating the current quality of teaching and learning of music in both primary and secondary schools. It aims to provide examples of best practice of teaching and learning of music, along with a set of recommendations for the development of future approaches and directions to improve the quality of music education offerings in Australian schools. This paper puts forward some proposals for consideration that will be forwarded to the Review and aims to generate debate about future approaches to the delivery of music education in Australian primary schools.
It argues that the home, school and community all have an important part to play in the music education of children, but that at present these three entities are insufficiently connected on a number of fronts, not least being an understanding about the purpose of young people’s engagement with music. There is no doubt that interest in the arts amongst Australians generally is high. A recent Australia Council report revealed that 85 per cent of its respondents agreed the arts are and should be an important part of the education of every young Australian and that what was needed was better arts education and opportunities for all young people. However, the opportunities need not be confined to those offered by the school sector. Engagement with out-of-school music includes both music encountered in the home, which may be affected by family influence, and music provided by the diversity of community organizations, which serve a real and complimentary role to classroom learning and achieve learning outcomes that schools often do not have the resources to foster. A number of proposals for action are suggested for consideration by those involved in education as a means of progressing the discussion. It asserts that there is much valuable activity occurring within the three locales of school, home and community, but a firmer relationship could be forged across all three to ensure young people’s on-going, life-long enjoyable engagement with music.

Comforting the afflicted and afflicting the comfortable: the role of journalism in the academy

The new professional disciplines such as journalism and public relations face unique challenges in entering the academy and as they formulate their own methodologies, pedagogies and theoretical frameworks there arises inevitable tensions between them and the more traditional disciplines.

As recently as January of this year in announcing the establishment of a new institute of journalism at Oxford University backed by £1.75m funding from Reuters, the vice chancellor of Oxford University, Dr John Hood, outlined plans to make this new centre one of the most authoritative sources of reliable analysis of journalism at an international, national and local level.

He went on to say that the aim of the institute would be to "break down the barriers of incomprehension and distrust which have tended to define the relationship between the academy and journalism." It is that ambivalent relationship which provides the focus for this paper.

As late as the mid 90s in the Australian academy focus was on the so called "Media Wars" with proponents of a pure and empirical form of journalism education declaring "No More Theory!" Tensions remain at least in the Australian context between the profession and practitioners and those who have moved to journalism education. Even within the ranks of the educators there are still divisions between those who see themselves only as practitioners with skills to impart, and those who see themselves as also building the disciplinary base.

Interdisciplinarity is often seen as the solution to such tensions but such hybrid mergings bring with them their own problems. This paper looks at the "Media Wars", their aftermath, and provides a case study of a discipline still seeking its own secure methodological and theoretical niche within the academy. It also poses its own solution in suggesting that it is time for a riotous Feyeraband type of play to produce the kind of disciplinary pastiche which will help in securing that niche.

Children's perceptions of the use of public open spaces for active free-play

Activity performed by children in their free-time may have a significant impact on overall physical activity levels, however, very little is known about the influences on children's active free-play. To examine the role and use of public open spaces, 132 children (6-12 years) from a selection of primary schools participated in small focus group interviews. Children reported that their use of public open spaces was influenced by a combination of intrapersonal, social and environmental factors including; the play equipment and facilities at local parks, lack of independent mobility, urban design features, presence of friends, and personal motivation.

Splanchnic blood flow and hepatic glucose production in exercising humans : role of renin-angiotensin system

The study examined the implication of the renin-angiotensin system (RAS) in regulation of splanchnic blood flow and glucose production in exercising humans. Subjects cycled for 40 min at 50% maximal O2 consumption (VO2 max) followed by 30 min at 70% VO2 max either with [angiotensin-converting enzyme (ACE) blockade] or without (control) administration of the ACE inhibitor enalapril (10 mg iv). Splanchnic blood flow was estimated by indocyanine green, and splanchnic substrate exchange was determined by the arteriohepatic venous difference. Exercise led to an ~20-fold increase (P < 0.001) in ANG II levels in the control group (5.4 ± 1.0 to 102.0 ± 25.1 pg/ml), whereas this response was blunted during ACE blockade (8.1 ± 1.2 to 13.2 ± 2.4 pg/ml) and in response to an orthostatic challenge performed postexercise. Apart from lactate and cortisol, which were higher in the ACE-blockade group vs. the control group, hormones, metabolites, VO2, and RER followed the same pattern of changes in ACE-blockade and control groups during exercise. Splanchnic blood flow (at rest: 1.67 ± 0.12, ACE blockade; 1.59 ± 0.18 l/min, control) decreased during moderate exercise (0.78 ± 0.07, ACE blockade; 0.74 ± 0.14 l/min, control), whereas splanchnic glucose production (at rest: 0.50 ± 0.06, ACE blockade; 0.68 ± 0.10 mmol/min, control) increased during moderate exercise (1.97 ± 0.29, ACE blockade; 1.91 ± 0.41 mmol/min, control). Refuting a major role of the RAS for these responses, no differences in the pattern of change of splanchnic blood flow and splanchnic glucose production were observed during ACE blockade compared with controls. This study demonstrates that the normal increase in ANG II levels observed during prolonged exercise in humans does not play a major role in the regulation of splanchnic blood flow and glucose production.

Macronutrient innovations: the role of fats and sterols in human health

Dietary intake of fats and sterols has long been known to play a critical role in human health. High proportions of saturated fat, which increase blood cholesterol levels, are mainly found in animal fat and some plant oil (e.g. cocoa butter, palm oil etc.). The predominant polyunsaturated fatty acid (PUFA) in the Western diet is linoleic acid (LA; 18:2n-6), an essential fatty acid, which is commonly found in vegetable seed oils. This is the parent fatty acid of n-6 series PUFA, which can be converted in vivo to C20 and C22 n-6 long chain (LC) PUFA. α‐linolenic acid (ALA; 18:3n-3) is less abundant than LA and is another essential fatty acid; ALA is also present in some vegetable oils such as perilla, flaxseed, canola, soybean and walnut oils, and is the precursor of C20 and C22 n-3 LC PUFA. Sterols are widely distributed in animal tissue and plants, with cholesterol being the major sterol in animal tissue and β-sitosterol, campesterol and stigmasterol being the main sterols in plants. It has long been recognized that an increased dietary intake of saturated fat and (to a lesser extent) cholesterol, raises plasma/serum total and low-density lipoprotein (LDL)-cholesterol, and PUFA decreases these levels. Results from recent studies have shown that plasma/serum levels of lipids and lipoprotein lipids can also be decreased by plant sterols (phytosterols) and diacylglycerol (DAG). Conjugated linoleic acid (CLA, cis-9,trans-11−18:2) has been reported to have anticancer and antidiabetic activities. Fat as the DAG form has also been reported to have anti-obesity effects. Omega-3 PUFA have a beneficial effect on increased heart rate variability, decreased risk of stroke, reduction of both systolic and diastolic blood pressure and may be effective in managing depression in adults. Gamma-linolenic acid (GLA) and phytosterols have an anti-inflammatory activity. The GLA, when combined with docosahexaenoic acid (DHA), have been reported to have a beneficial effect in hyperactive children. These data show that various lipids are powerful bioactive compounds.

The interface of acute and aged care: the role of the nurse in provincial area

Objective: This study was to investigate issues that arose from pre-admission to post-discharge, for people in Toowoomba, Queensland over the age of 65 admitted to an acute facility. This paper concentrates on a significant concern that emerged from the latge amount of data collected during this project, that is, the role of the nurse in the continuum of health care involving elderly people.

Method: The study involved a multi-site, multi-agency and multi-method (qualitative and quantitative) approach. Data was collected from regional service providers, the Department of Health and Aged Care (DHAC), the Australian Bureau of Statistics (ABS), Home and Community Care (HACC), the Aged Care Assessment Team (ACAT), elderly people who had been discharged from regional hospitals and their carers, residents of regional aged care facilities, area health professionals and elderly regional hospital inpatients.

Results: The data indicated that nurses in this provincial area currently play a limited role in preadmission planning, being mostly concerned with elective surgery, especially joint replacements. While nurses deliver the majority of care during hospitalisation, they do not appear to be cognizant of the needs of the elderly regarding post-acute discharge.

Conclusion: The recent introduction of the model of nurse case management in the acute sector appears to be a positive development that will streamline and optimise the health care of the elderly across the continuum in the Toowoomba area. The paper recommends some strategies, such as discharge liaison nurses based in Emergency Departments and the expansion of the nurse case management role, which would optimise care for the elderly person at the interface of care.

The role of communication in meeting MPA objectives

Marine Protected Areas (MPAs) play an important role in conserving the marine environment. An integral part of managing MPAs is communicating to its users and the broader community the existence of the park and its regulations. In two studies looking at the Victorian Marine National Parks and Sanctuaries it was found that there was a low level of awareness of the parks existence [1]. Television news was found in both studies to account for the majority of respondents awareness yet television advertisements were the main media used to inform the community, along with signage at parks and sanctuaries [2].

Education and communication are the main ways that management agencies inform the broader community about the parks and the regulations governing their management. They are generally directed at two main groups: formal education within schools and universities and communication towards the wider community. Communicating to the broader community the existence of an MPA is achieved through signs, brochures, self guided or ranger walks. These are developed by education experts within management agencies. Yet little is known of the public’s level of knowledge about MPAs or the marine environment. Therefore, our research aims to discover the communities existing knowledge of MPAs and the marine environment and how this can help create effective communication strategies. This research focuses on the public who use MPAs and the wider community in Victoria, Queensland and Western Australia.

Publishing in socially oriented journals - the state of play in Asia

Purpose: This paper examines this issue by examining institutional publishing in six socially oriented marketing journals generally and then explores the performance within Asian institutions and those within Australia and New Zealand, in detail.

Design/Methodology/Approach: Authorships of Journal of Macromarketing, Journal of Public Policy & Marketing, Journal of Consumer Affairs, Journal of Non-Profit and Public Sector Marketing, International Journal of Non-Profit and Voluntary Sector Marketing, and Social Marketing Quarterly, from 1999-2003 were tracked, by institution and nationality of school. Results are reported for both number of authors and percent of authorship.

Findings: There is a dominance of publishing by North American Academics within the social area. Asia academics appear to be generally under-represented, based on the region’s size, although scholars in Australia and New Zealand perform relatively better than one might anticipate.

Research Limitations/Implications: A review of socially oriented publishing performance by institutions in Asia identifies that socially oriented research appears to be a focus in Australia and New Zealand across a range of institutions, but occurs less frequently in other Asian countries.

Practical Implications: Results are useful for understanding the role of socially oriented research among scholars in Asia and the Pacific. While Australia and New Zealand have made marks in socially oriented research, it appears to be a potential “growth area” for marketing scholars in Asia and the Pacific.

Originality/Value: This is the first paper to examine the role of geography in publishing among those interested in social issues in marketing.

Review of the role of emergency nurses in management of chemotherapy-related complications

Aims and objectives : To examine the role of emergency nurses in caring for patients who receive chemotherapy in ambulatory oncology settings. Reasons for emergency department presentations are examined, specific sources of clinical risk for patients receiving chemotherapy who require emergency care are discussed and cost implications of emergency department presentations related to chemotherapy are analysed.

Background : Given the increased administration of chemotherapy in ambulatory settings, emergency nurses play an important role in the management of patients undergoing adjuvant chemotherapy. Emergency departments are the major entry point for acute inpatient hospital care of complications arising from chemotherapy.

Design : Systematic review.

Results : Chemotherapy-related emergency department presentations have considerable clinical and cost implications for patients and the healthcare system. Strategies to improve emergency department management of chemotherapy complications and reduction in preventable emergency department presentations has significant implications for improving cancer patients' quality of life and reducing the cost of cancer care.

Conclusions : Nurses are well placed to play a pivotal role in chemotherapy management and lead interventions such as a specialist oncology nursing roles that provide information and support to guide patients through their chemotherapy cycles. These interventions may prevent emergency department presentations for patients receiving chemotherapy in ambulatory settings.

Relevance to clinical practice : Patients receiving chemotherapy require access to specialised care to manage distressing symptoms, as they are at significant clinical risk because of immunosuppression and may not exhibit the usual signs of critical illness. A team approach both within and across nursing specialities may improve care for patients receiving chemotherapy and increase effective use of healthcare resources.