Improving health with nutritional interventions in residential aged care

In a group of Australian aged care residents, dietary energy and nutrient intakes were generally inadequate, despite sufficient energy being served. Six months of multivitamin supplementation improved nutritional status and bone quality; and six months of fortified milk consumption improved serum 25(OH)D and folate levels, and increased vitamin D and folate intakes.

Power relationships in a residential facility for disabled people : a critical ethnographic account

This study comprises an ethnography and exlores caring, as expressed through inter-relationships, coalitions and conflicts between nurses, residents and others within a bureaucratic setting. Observation, reflection on practice, and professional journalling were used to identify unexamined beliefs which lay hidden in day-to-day practices. An action research project was developed to introduce a small change in practice. It was found that the bureaucratic need for predictability and stability militated against this change.

Evaluation of individual program plan content and quality in a Victorian residential service

The study assesses the quality and content of Individual Program Plans for 284 Victorian adults with profound intellectual disabilities living in one residential service. A checklist was developed for improving plan quality, and measurement difficulties with checklists discussed. Recommends that a quality improvement process be implemented.

The clinical utility of a suite of continence assessment tools for use in residential aged care facilities

According to the Institute of Medicine of the National Academies, 80% of direct care in nursing homes in the USA is provided by workforce that has least formal education about patient care (1). This situation is echoed in Australian residential aged care facilities where the day-to-day management is largely provided by unregulated workers (i.e. nursing assistants, personal carers and nursing aides) and is overseen by registered nurses. Some facilities additionally have access to expert advice from continence nurse advisors. In order to assist the residential aged care workforce to provide continence care that is evidence-based, a team of researchers developed and trialled a suite of continence assessment tools that were mainly targeted to unregulated workers. This paper presents information on the development of the tools (Stage 1) and on their evaluation (Stage 2).

Associations of residential density with adolescents’ physical activity in a rapidly urbanizing area of mainland China

In the context of recent social and economic transitions in China, lack of physical activity among adolescents is an emerging health risk, particularly so in rapidly expanding urban areas. Evidence from Western countries suggests that built environment attributes can influence the physical activity participation of young people, but whether or not this is the case for China is unknown. We recruited high school students from ten urban districts in Nanjing, Mainland China (n=2,375; mean age=13.9± 1.0 years old; 46% boys; survey response rate=89%). The outcome variable was selfreported recreational physical activity time; the primary explanatory variable was the residential density of the urban districts. Analysis was conducted using mixed-effects logistic regression models. After adjustment for potential confounding variables, including sedentary behavior and green space, there was a consistent and graduated association between residential density and physical activity; residential density was significantly negatively associated with recreational physical activity time for students from the higher tertile of residential density (OR; 95% CI=0.64; 0.42 to 0.97) compared to those from the lower tertile. The direction and magnitude of the negative association between residential density and physical activity was similar for boys and girls. It should be a public health priority to identify the particular urban environment attributes that can encourage and support young people’s participation in physical activity.

Residential density and adolescent overweight in a rapidly urbanising region of mainland China

Objective This study investigated the association of residential density with overweight among adolescents in an urban area of China.

Methods Using multistage proportional sampling methods, a population-based cross-sectional study was conducted in Nanjing between September and November 2004 (n=2375; mean age=13.9+/-1.0 years old; 46.2% boys; survey response rate=89.3%). Body mass index was calculated from self-reported body weight and height. Overweight, the main outcome variable, was defined as a BMI >/=85 percentile value for age- and gender-specific reference data according to the recommendation for Chinese adolescents. The primary explanatory variable was the residential density of the urban districts. Mixed-effects logistic regression models were used for the analysis.

Results Students in the higher and middle tertiles of residential density had a 2.17-fold (95% CI 1.41 to 3.33) and 1.89-fold (95% CI 1.22 to 2.92) higher likelihood of being overweight, respectively, compared with those in the lower tertile. The associations were slightly attenuated but still significant after adjusting for time spent in recreational physical activity and sedentary behaviour (viewing TV and sitting for academic study).

Conclusions Residential density was positively associated with overweight among urban Chinese adolescents. Our findings warrant further research examining attributes of urban environments associated with adolescents' obesity in China and potential mechanisms between them.

Use of restraint in residential care settings for children and young people

An international movement promoting the reduced use of physical restraint and other coercive practices has brought into focus the ways in which those who are responsible for the care of children and young people respond to problematic behaviour. The topic generates emotive discussion, with proponents advancing the argument that the use of coercive measures enhances the quality of care and protects young people from harm, and civil libertarians who argue that restraint is never an appropriate way of managing behaviour. Despite such debates there is an absence of good research and scholarly activity on restraint practices, leading to uncertainty about the immediate and long-term effects of particular practices on both staff and young people. Consequently, it has been difficult for agencies to develop clear, consistent, and definitive policies. Drawing on international perspectives, the aim of this article is to discuss issues relevant to the practice of restraint in residential care facilities for children and young people in Australia, highlighting a number of issues that require resolution prior to the development of practice guidelines.

Parental perceptions of residential location : impacts on children's health

This study explored families’ views and experiences of their residential location in relation to their children's health. Thematic analysis of interviews with mothers revealed that decisions to live in an outer Melbourne municipality were strongly influenced by ideals around children however; all spoke of experiencing difficulties in raising children in terms of accessing services, recreation facilities, transport and work. Analysis of these findings using Bronfenbrenner's Social Ecology Model revealed how factors could interact to affect children's health and wellbeing. The study findings highlight the importance of parental perceptions of residential location in understanding the relationship between children's health and place.

The Canadian response to Aboriginal residential schools : lessons for Australia and the United States?

The common policy of the Australian, Canadian and United States governments of removing aboriginal children from their families and placing them in institutions is now well documented. This article considers the responses to the stolen generations in Australia, Canada and United States. A major focus of the article is the historic compensation package agreed to by the Canadian government. Whilst the Canadian federal government has not been without criticism on this issue, it must be applauded for its efforts to meet a peaceful solution to a tragic past. The political responses in Australia and United States and Canada are simply incomparable. The failure to address the plight of the stolen generations of Australia and the United States evidences a major failing in Indian/Aboriginal policy in these two nations that needs to be addressed. Australia and the United States have much to learn from the reconciliatory policies of the Canadian government.

Residential auction clearance rates – what do they really mean?

The residential market in Melbourne is often referred to as the ‘auction capital of the world’ with approximately 30-35% of housing transfers undertaken via the auction process, most of which are conducted on the weekend and then reported in the media the following day. The most quoted measurement of auction success is via the clearance rate which simply indicates the proportion of signed contracts of sale within the auction process. At the same time the clearance rate can have a relatively large variance where the residential market can traditionally range from very good (i.e. a high clearance rate) to very poor (i.e. a low clearance rate). The subsequent effect on the market can directly increase or decrease demand, predominantly based only on this single measure of the perceived level of auction clearance rates only.

This paper examines the concept of the auction clearance rates and the heavy reliance on the only one measure of success (i.e. the clearance rates), regardless of other variables. The emphasis is placed on the auction clearance rate as one measure of demand in the housing market but within the context of the definition of market value i.e. willing buyer-willing seller. This is supported by a discussion about other variables including the asking price, the auction process itself, marketing considerations and seasonal adjustments. The findings provide an insight into how to correctly interpret the auction clearance rate in the context of the overall supply-demand interactions. Whilst the auction process is clearly an integral part of the residential transfer process it is essential that the auction clearance rate is used with caution and also in conjunction with other variables.

Dialysis residential care : a future dialysis service model

People with chronic kidney disease are ageing and have increasing co-morbidities. The current delivery of renal replacement therapy, dialysis and transplantation, needs to adjust to changing patient needs. This paper proposes a potential future service delivery model featuring a dialysis residential care facility and a care coordination focus. The residential care facility would be composed of four levels of care; high, hostel, independent and outpatient. The paper argues that this model may result in decreased morbidity, improved patient quality of life and may prove cost effective. Patients' nutritional status, medication adherence and transport efficiency may be improved. We propose this model to stimulate further debate in order to meet the needs of current and future chronic kidney disease patients.