Ebia Olewale : a life of service

style="font-size: 11pt; font-family: Calibri;">Over the last seven decades, Papua New Guinea (PNG) has grown from a disparate collection of traditional societies loosely governed by its neighbour, Australia, to a thriving, developing state. The story of how PNG came to lose its colonial shackles and gain independence is one of collective endeavour, as the tiny group of Papua New Guineans who gathered in the dusty streets of Port Moresby transformed into the leaders of the new nation. One of them was the young teacher, Ebia Olewale, who in his own journey from the village to the nation experienced many triumphs and tragedies. PNG’s story – from the village to the world – is retold in this book, through the experiences of Ebia Olewale.

Effect of a telephone-delivered coronary heart disease secondary prevention program (ProActive Heart) on quality of life and health behaviours: primary outcomes of a randomised controlled trial

Background Participation in coronary heart disease secondary prevention programs is low. Innovative programs to meet this treatment gap are required.

Purpose To aim of this study is to describe the effectiveness of a telephone-delivered secondary prevention program for myocardial infarction patients.

Methods Four hundred and thirty adult myocardial infarction patients in Brisbane, Australia were randomised to a 6-month secondary prevention program or usual care. Primary outcomes were health-related quality of life (Short Form-36) and physical activity (Active Australia Survey).

Results Significant intervention effects were observed for health-related quality of life on the mental component summary score (p = 0.02), and the social functioning (p = 0.04) and role-emotional (p = 0.03) subscales, compared with usual care. Intervention participants were also more likely to meet recommended levels of physical activity (p = 0.02), body mass index (p = 0.05), vegetable intake (p = 0.04) and alcohol consumption (p = 0.05).

Conclusions Telephone-delivered secondary prevention programs can significantly improve health outcomes and could meet the treatment gap for myocardial infarction patients.

Are animal personality traits linked to life-history productivity?

Animal personality traits such as boldness, activity and aggressiveness have been described for many animal species. However, why some individuals are consistently bolder or more active than others, for example, is currently obscure. Given that life-history tradeoffs are common and known to promote inter-individual differences in behavior, we suggest that consistent individual differences in animal personality traits can be favored when those traits contribute to consistent individual differences in productivity (growth and/or fecundity). A survey of empirical studies indicates that boldness, activity and/or aggressiveness are positively related to food intake rates, productivity and other life-history traits in a wide range of taxa. Our conceptual framework sets the stage for a closer look at relationships between personality traits and life-history traits in animals.

End-of-life care for aged care residents presenting to emergency departments

Background: The number of patients from Aged Care presenting to acute care is increasing, many of whom have a life limiting illness.

Aims: To identify differences in relation to Aged Care Residents presenting to Emergency departments who died during a hospital admission compared to those who were referred to the hospital based palliative care.

Methods: Review of a stratified random sample of 90 Aged Care residents transferred to acute care who died during admission in 2009; half the sample received palliative care. Comparisons were made with regard to age; gender; co-morbidities; symptoms, investigations and active treatment; prior admissions and costs.

Results: The median age of patients was 87.5 years, 61% were female and 38% had three or more admissions in the year prior to death. Patients with a length of stay of four or more days were 2.98 times (CI, 95%:1.11-8.03) and patients with agitation were 3.08 (CI 95%:1.10- 8.64) times more likely to be referred to palliative care. Patients who received palliative care had significantly fewer investigations or active treatment in the 24 hours prior to their death (p< 0.01) and palliated patients had significantly lower average costs per day of admission ($1022, SD=$441) compared to those who were not palliated ($ 831; SD= $ 1041) (p< 0.001).

Discussion: Our study indicates there is a difference between dying patients who received palliative care compared to those who did not in an acute care setting. Further research into the outcomes of patients discharged back to Aged Care facilities for palliative care warrants investigation.

Determinants of health-related quality of life in people with Parkinson’s disease: a path analysis

Purpose:
To identify the demographic factors, impairments and activity limitations that contribute to health-related quality of life (HRQOL) in people with idiopathic Parkinson’s disease (PD).

style="font-size: 12px;">Method:
Two hundred and ten individuals with idiopathic PD who participated in the baseline assessment of a randomized clinical trial were included. The Parkinson’s Disease Questionnaire-39 summary index was used to quantify HRQOL. In order to provide greater clarity regarding the determinants of HRQOL, path analysis was used to explore the relationships between the various predictors in relation to the functioning and disability framework of the International Classification of Functioning model.

Results:
The two models of HRQOL that were examined in this study had a reasonable fit with the data. Activity limitations were found to be the strongest predictor of HRQOL. Limitations in performing self-care activities contributed the most to HRQOL in Model 1 (β = 0.38; p < 0.05), while limitations in functional mobility had the largest contribution in Model 2 (β = −0.31; p < 0.0005). Self-reported history of falls was also found to have a significant and direct relationship with HRQOL in both models (Model 1 β = −0.11; p < 0.05; Model 2 β = −0.21; p < 0.05).

Conclusions:
Health-related quality of life in PD is associated with self-care limitations, mobility limitations, self-reported history of falls and disease duration. Understanding how these factors are inter-related may assist clinicians focus their assessments and develop strategies that aim to minimize the negative functional and social sequelae of this debilitating disease.

Parents' and children's views on whether active video games are a substitute for the 'real thing'

Background:
Research has examined the energy cost associated with playing seated and active video games (AVGs), but not whether AVGs may benefit fundamental movement skills (FMS) in typically developing children. Improving FMS proficiency is a priority given its association with physical activity. This study aimed to identify children’s and parents’ perceptions of: (1) AVGs as a tool for developing FMS and (2) whether any skills gained during AVG play had potential to transfer to real life.

Methods:
This qualitative descriptive study included 29 parents of children aged 9–10 years who participated in semi-structured telephone interviews and 34 children who participated in six group discussions at school. Interview and discussion group data were recorded, transcribed and analysed thematically.

Results:
Parents and children had different perspectives on the potential of AVGs for FMS, which largely rested on different views of ‘reality’. Parents felt AVGs were not a substitute for the ‘real thing’, and therefore had limited FMS benefits. Overall, parents thought any FMS gained through AVGs would have poor transferability to ‘real life’. In contrast, children had a more fluid and expansive view of reality which incorporated both ‘real life’ and ‘virtual’ space. Whilst children could articulate limitations of AVGs for skill learning, they still reported extensive use of AVGs as a learning tool for movement skill, and considered that skill acquisition was highly transferable.

Conclusions:
Despite contrasting beliefs from parents and children, children used AVGs for FMS learning. Future research needs to determine whether actual FMS benefits are gained through AVGs.

The musical and social benefits of community choir membership in Melbourne (Australia)

Finding a place for personal growth in an Australian community singing group for older people

style="font-size:12.0pt;font-family:"Times New Roman"; mso-fareast-font-family:"ＭＳ 明朝";mso-fareast-theme-font:minor-fareast; mso-ansi-language:EN-AU;mso-fareast-language:EN-US;mso-bidi-language:AR-SA">As in many countries, Australia is faced with an aging population. This creates challenges for the maintenance of well-being which can be enhanced by active engagement in society. Music engagement encompasses a range of social participation and has the potential to recognise the contribution of older people to their local communities.style="color:red"> Engagement in music by older people (50+) is positively related to individual and community well-being.  Music participation can contribute to a better quality of life, particularly in relation to health and happiness. The possible forms of music engagement are myriad.

This paper focuses on two members of a mixed voluntary singing group formed by older residents of an outer suburban community in Melbourne, Australia.  This study frames music as a positive way for older people to find a place for personal growth and fulfilment in a singing group. This phenomenological qualitative single case study focuses on two members of a small singing ensemble, the Skylarkers, formed to perform at retirement villages, nursing homes and facilities for senior citizens.style="color:red"> In this study, data were gathered by interviews and analysed using interpretative phenomenological analysis.

Two significant themes emerged. The first concerned the nature of the choir and its fluid membership and notions of self-identity. The second theme concerns the validation offered to individual members by active music participation through which they gained a sense of purpose, fulfilment and personal growth. This emphasis is unusual in discussions of community music engagement that ordinarily identify the importance of social connections. Groups such as the Skylarkers provide a place for members to continue their active engagement with music performance and music learning.

Associations of leisure-time physical activity with quality of life in a large, population-based sample of colorectal cancer survivors

Objective : To examine the associations between physical activity and quality of life for colorectal cancer survivors; and to describe the associations of medical and sociodemographic attributes with overall quality of life, and their moderating effects on the relationships between physical activity and quality of life.

Methods : Telephone interviews were conducted with 1,996 colorectal cancer survivors recruited through the Queensland Cancer Registry. Data were collected on current quality of life; leisure-time physical activity pre- and post-diagnosis; cancer treatment and side-effects; and general sociodemographic attributes. Hierarchical generalized linear models identified variables significantly associated with quality of life.

Results : After controlling for sociodemographic variables, disease-specific variables, treatment side-effects, and pre-diagnosis leisure-time physical activity, there were significant differences in quality of life scores by post-diagnosis physical activity category. Compared to participants who were inactive after their diagnosis, those who were sufficiently active had a 17.0% higher total quality of life score. Physical activity also had a significant independent positive association with the physical well-being, functional well-being, and additional concerns subscales of the FACT-C.

Conclusions : Our findings demonstrate that quite modest changes in leisure-time physical activity are associated with quality of life. Colorectal cancer survivors may benefit from a more active lifestyle.

Additional Saturday rehabilitation improves functional independence and quality of life and reduces length of stay: a randomised controlled trial

style="font-size: 12px">Background

style="line-height: 160%">Many inpatients receive little or no rehabilitation on weekends. Our aim was to determine what effect providing additional Saturday rehabilitation during inpatient rehabilitation had on functional independence, quality of life and length of stay compared to 5 days per week of rehabilitation.

style="line-height: 160%">This was a multicenter, single-blind (assessors) randomized controlled trial with concealed allocation and 12-month follow-up conducted in two publically funded metropolitan inpatient rehabilitation facilities in Melbourne, Australia. Patients were eligible if they were adults (aged ≥18 years) admitted for rehabilitation for any orthopedic, neurological or other disabling conditions excluding those admitted for slow stream rehabilitation/geriatric evaluation and management. Participants were randomly allocated to usual care Monday to Friday rehabilitation (control) or to Monday to Saturday rehabilitation (intervention). The additional Saturday rehabilitation comprised physiotherapy and occupational therapy. The primary outcomes were functional independence (functional independence measure (FIM); measured on an 18 to 126 point scale), health-related quality of life (EQ-5D utility index; measured on a 0 to 1 scale, and EQ-5D visual analog scale; measured on a 0 to 100 scale), and patient length of stay. Outcome measures were assessed on admission, discharge (primary endpoint), and at 6 and 12 months post discharge.

style="line-height: 160%">We randomly assigned 996 adults (mean (SD) age 74 (13) years) to Monday to Saturday rehabilitation (n = 496) or usual care Monday to Friday rehabilitation (n = 500). Relative to admission scores, intervention group participants had higher functional independence (mean difference (MD) 2.3, 95% confidence interval (CI) 0.5 to 4.1, P = 0.01) and health-related quality of life (MD 0.04, 95% CI 0.01 to 0.07, P = 0.009) on discharge and may have had a shorter length of stay by 2 days (95% CI 0 to 4, P = 0.1) when compared to control group participants. Intervention group participants were 17% more likely to have achieved a clinically significant change in functional independence of 22 FIM points or more (risk ratio (RR) 1.17, 95% CI 1.03 to 1.34) and 18% more likely to have achieved a clinically significant change in health-related quality of life (RR 1.18, 95% CI 1.04 to 1.34) on discharge compared to the control group. There was some maintenance of effect for functional independence and health-related quality of life at 6-month follow-up but not at 12-month follow-up. There was no difference in the number of adverse events between the groups (incidence rate ratio = 0.81, 95% CI 0.61 to 1.08).

style="line-height: 160%">Providing an additional day of rehabilitation improved functional independence and health-related quality of life at discharge and may have reduced length of stay for patients receiving inpatient rehabilitation. 

Crafts and successful aging: the Découpage Guild Australia

David Bowie: dancing with madness and proselytising the socio-political in art and life

style="color: rgb(73, 72, 72); font-family: ff-dagny-web-pro, 'Helvetica Neue', Arial, sans-serif; line-height: 18px;">A longstanding, successful and frequently controversial career spanning more than four decades establishes David Bowie as charged with individual agency. The notion of ‘agency’ here refers particularly to the ‘ability of people, individually and collectively to influence their own lives and the society in which they live’ (Germov and Poole, 2007: 7). That Bowie has influenced many lives is undeniable to his fans. He has long demonstrated an avid curiosity for the enduring patterns of social life which is reflected in his art. Bowie’s opus contains the elements of ideological narratives around sexual (mis)adventure, expressivity, and; resistance to ‘normative’ behaviour. He requisitions his audiences, through frequently indirect lyrics and images, to critically question sanity, identity and essentially what it means to be ‘us’ and why we are here. Here, in this context, ‘dancing with madness’ assumes an intimate relationship, even if brief, where ideas and emotions come passionately together for the purpose of creative expression much like the intertwining and energetic performance of the partner dance Tango. As such, ‘dancing’ is argued here to be an appropriate descriptor for how Bowie has engaged with creative cultural forms but not meant to be self-conscious nor indicate superficiality or ignorance. The idea of madness for its part is a theme in many of his compositions, for example the original album cover for The Man Who Sold the World (1971)  depicts an asylum and includes the song ‘All The Madmen’ and Aladdin Sane (1973)—a lad insane--are but two examples. This paper argues that Bowie’s frequently astute contemplations, manifest through his art over a period now spanning more than forty years, continues to draw fans of like mind to his work with the result that he has a legitimate claim to influence and affect.

Exploring and expressing Italian musical heritage in Melbourne (Australia): a women’s community choir

style="line-height:150%">Australia comprises many cultures, ethnicities, and languages. Belonging to community music groups by older people can enhance quality of life, offer a sense fulfilment, and provide a space through which cultural and linguistic identity may be shared and celebrated. This qualitative case study explores engagement by older members of La Voce Della Luna, an Italian women’s community choir based in Melbourne, Victoria. Older Australians, particularly those from culturally and linguistically diverse backgrounds frequently rely on voluntary community arts organisations to enhance quality of life. Singing together can provide ways for individuals and communities to express themselves, build community identity, improve quality of life, and celebrate cultural heritage. The members of the choir know that under their inspiring conductor they would learn new songs, new languages and new ways of performing. Their music director saw that the women’s singing together opened new horizons of social engagement and new ideas such as social justice and women’s rights.
This case is from the larger ongoing joint research project (2008 ongoing), Well-being and ageing: community, diversity and the arts in Victoria. Data were gathered from documentary sources and by individual and focus group semi-structured interviews (2013) and were analysed using interpretative phenomenological analysis. Significant themes emerged: social connection and combatting isolation, the maintenance and transmission of cultural heritage, and opening horizons about music making and social justice. This paper demonstrates that active music making makes it possible for older women to learn new skills, new ideas, and create for themselves a resilient community.

Anxiety in the management of localised prostate cancer by active surveillance

To describe a range of anxieties in men on active surveillance (AS) for prostate cancer and determine which of these anxieties predicted health-related quality of life (HRQL).