Preventing falls among older people : current practice and attitudes among community pharmacists

Objective: Falls among older people are a major cause of injury and death in Australia Urgent action is required if we are to stem the .epidemic' increase in falls as our population ages. This paper describes current practice and attitudes of community pharmacists in Northern Rivers, New South Wales, in relation to preventing falls. .. Method: Comm~typhannacists in the Northern Rivers area ofNew South Wales were surveyed to detennine their current activities to reduce the risk of falls in older clients and to gauge awareness of the successful 1992-96 falls prevention program- 'Stay on Your Feet'. Results: Response rate was 79% (53/67). Seventy-two per cent reported that they urge 'most' or 'almost all' older clients to bring in out-of-date medications for disposal, 66% give them falls prevention advice at least 'sometimes', 57% refer at least 'some' older clients to allied health practitioners for assessment or treatment of falls risk. and 92% are interested in receiving more written information regarding falls prevention. Conclusion: The fmdings suggest that while community pharmacists are both ready and keen to play a role in future falls prevention initiatives. their current involvement varies considerably. Specific ways in which they might further help to reduce falls are: regularly checking the potential of client. medications to connibute to falls. giving more verbal or written advice, promoting 'falls safe' products, referring older clients to allied health practitioners for assessment or treatment of falls risk, and training staff [Q provide falls prevention advice

Relationship of heart failure patients' knowledge, perceived barriers, and attitudes regarding low-sodium diet recommendations to adherence.

The purposes of this study were to describe heart failure patient perceptions regarding instructions received for following a low-sodium diet and the benefits, barriers, and ease and frequency of following the diet. A total of 246 patients with heart failure referred from academic medical centers in the United States and Australia participated in the study. A subset of 145 patients provided 24-hour urine samples for sodium excretion assessment. While most (80%) patients reported receiving recommendations to follow a low-sodium diet, their recall of specific instructions was poor. Although the majority (75%) reported following a low-sodium diet most or all of the time, 24-hour urine sodium excretion indicated that only 25% of patients were adherent. Patients who reported being more adherent, however, had lower urine sodium excretion levels. Attitudes regarding difficulty in and perceived benefits of following the diet were not related to sodium excretion. Data on attitudes and barriers provided guidance for strategies to improve adherence.

Academic and business ethical misconduct and cultural values : a cross national comparison

Efforts to promote ethical behaviour in business and academic contexts have raised awareness of the need for an ethical orientation in business students. This study examines the similarities and differences between the personal values of Iranian and Australian business students and their attitudes to cheating behaviour in universities and unethical practices in business settings. Exploratory factory analysis provided support for three distinct ethics factors—serious academic ethical misconduct, minor academic ethical misconduct, and business ethical misconduct. Results reveal statistically significant differences between the two cultural groups for ethical (altruism/universalism) values, and for attitudes to serious academic misconduct. No differences were found between the two groups for attitudes to minor academic unethical practices or unethical business practices. Gender influenced responses where females were found to indicate higher levels of unacceptability of unethical practices in academic and business settings than males. This pilot study highlights the need for higher education institutions to develop and enforce policies and practices to publicise, encourage and reinforce higher awareness of the need for adhering to ethical behaviour in university studies as a necessary component of training business professionals.

Women clinical nurses' constructions of collegiality : an ethnomethodological study

This research is about a shared journey of being together. It involved thirteen women nurses (including myself) in a process approach to working with data collected through audio transcriptions of conversations during group get-togethers, field notes and journalling over twelve months. The project was conducted in a large acute care metropolitan hospital where the ward staff interests lie in a practice history of the medical specialty of gynaecology and women's health. Prior to commencement ethical approval was gained from both the University and hospital ethics committees. Accessing the group was complicated by the political climate of the hospital, possibly exaggerated further by the health politics across the state of Victoria, at a time of major upheaval characterised by regionalism, rationalisation and debt servicing. In order to ascertain women clinical nurses' constructions of collegiality I adopted an ethnomethodological approach informed by a critical feminist lens to enable the participants to engage in a process of openly ideological inquiry, in critiquing and transforming practice. I felt the choice of methodology had to be consistent with my own ideological position to enable me to be myself (as much as I could) during the project. I wanted to work with women to illuminate the ways in which dominant ideologies had come to be apprehended, inscribed, embodied and/or resisted in the everyday intersubjective realities of participants. The research itself became a site of resistance as the group became aware of how and in what ways their lives had become distorted, while at the same time it collaboratively transformed their individual and collective practice understandings, enabling them to see the self and other anew. Set against the background of dominant discourses on collegiality, women's understandings of collegiality have remained a submerged discourse. Revealed in this work are complex inter-relationships that might be described by some as collegial!, but for others relations amongst these women depict alternative meanings in a rich picture of the fabric of ward life. The participants understand these relations through a connectedness that has empathy as its starting point. In keeping with my commitment to engage with these women I endeavoured to remain faithful to the dialogical approach to this inquiry. Moreover I have brought the voices of the women to the foreground, peeling away the rhizomatic interconnections in and between understandings. What this has meant in terms of the thesis is that the work has become artificially distanced for the purposes of academic requirements. Nevertheless it speaks to the understandings the participants have of their relationships; of the various locations of the visible and invisible voices; of the many landscapes and images, genealogies, subjectivities and multiple selves that inform the selves with(in) others and being-in-relation. Throughout the journey meanings are revealed, revisited and reconstructed. Many nuances comprise the subtexts illuminating the depths of various moral locations underpinning the ways these women engage with one another in practice. The process of the research weaves through multiple positions, conveying the centrality of shared goals, multiple identities, resistances and differences which contribute to a holding environment, a location in which women value one another in their being-in-relation and in which they stand separately yet together.

Being academic

This research draws on the theoretical resources of Foucault and Bourdieu to focus on the complex relationship between the introduction of a range of new technologies, the lived experience of being academic and the often contradictory subjectivities within the power relations of the managed university in the 21st Century.

International postgraduate students experience in a UK university : lessons for academic practice

This paper reports on a study of the international postgraduate student experience in a United Kingdom (UK) university, using a case study approach. Looking at both the academic and non academic experience of students in the university, the paper attempts to identify differences in perceptions of staff and students on key issues related to the international student experience. The limited sample of this study is compensated for by the quality and depth of data obtained from in-depth interviews with students and staff in one UK university. Results indicate significant convergence of perceptions in relation to the quality of education in the UK though the issues of cultural integration, English language and inadequate student support and the serious threat these issues pose to the quality of experience for students. The paper identifies five key gaps in the way staff and students conceptualise the postgraduate student experience and concludes with suggestions for how management might narrow these gaps in the higher education context.

Language, technology and the law : anti-plagiarism software and students' academic writing

Plagiarism is of grave concern for academic institutions in the twenty-first
century. Institutions utilise plagiarism policies, honour codes and regulations to ensure students develop a sense of educational integrity. Technology has recently afforded new methods for staff to detect plagiarism – through antiplagiarism software. This paper explores perspectives of seven teachers across five faculties to Turnitin.com (an anti-plagiarism software package) at a large Australian university. The findings indicate that software such as Turnitin.com may assist in the quest to detect text-matching, and perhaps reduce plagiarism. It should not, however, be considered the panacea for plagiarism. Plagiarism policies should also reflect cognisance of the existence of a 'plagiarism continuum' (Sutherland-Smith, 2003) through the use of technology. This research highlights the broader need for institutions to reformulate plagiarism policies in light of cross-cultural perspectives of authorship and attribution of text.

Intervention for depression among palliative care patients and their families : a study protocol for evaluation of a training program for professional care staff

Background: Clinical depression is highly prevalent yet under-detected and under-treated in palliative care settings and is associated with a number of adverse medical and psychological outcomes for patients and their family members. This article presents a study protocol to evaluate a training intervention for non-physician palliative care staff to improve the recognition of depression and provide support for depressed patients and their family members. Details of the hypotheses and expected outcomes, study design, training program development and evaluation measures are described.
Methods and Design: A randomised controlled trial will be implemented across two palliative care services to evaluate the “Training program for professional carers to recognise and manage depression in palliative care settings”. Pre-, post- and three-month follow-up data will be collected to assess: the impact of the training on the knowledge, attitudes, self-efficacy and perceived barriers of palliative care staff when working with depression; referral rates for depression; and changes to staff practices. Quantitative and qualitative methods, in the form of self-report questionnaires and interviews with staff and family members, will be used to evaluate the effectiveness of the intervention.
Discussion: This study will determine the effectiveness of an intervention that aims to respond to the urgent need for innovative programs to target depression in the palliative care setting. The expected outcome of this study is the validation of an evidence-based training program to improve staff recognition and appropriate referrals for depression, as well as improve psychosocial support for depressed patients and their family members.

An exploratory study of ethical dilemmas faced by academic leaders in three Australian universities

Being an academic in universities today is characterised by change and increasing complexity in response to a multitude of factors impacting on the university sector. Among the consequences of such changes are that many academics, and academic leaders in particular, are subjected to both increasing stress and scrutiny in many of the decisions they make. Some of these decisions require critical choices that involve contestation of values (including personal, professional, institutional, and community), resulting in ethical dilemmas for the decision makers. This article reports on an exploratory study into ethical dilemmas faced by middle-level academic leaders, drawing on the results of an on-line survey distributed to relevant academics in three universities in Australia. Here, middle-level academic leaders are defined as those holding course coordination roles, locating them between senior university staff and other academics on the one hand, and students on the other hand. As a consequence, these diverse groups of staff and students potentially have an array of conflicting interests in, and expectations on, middle-level academics’ decision-making processes. The findings of the study are clear: ethical dilemmas are evident, and commonly so, for many middle-level academic leaders. While exploratory in nature, the findings of this study suggest that much more attention to ethics and ethical dilemmas is needed in our universities.

Transforming an academic library's spaces : an evaluation study of Deakin University Library at Burwood campus using TEALS discovery

Libraries worldwide are transforming their spaces to better align with the changing needs of their communities. The aim of this paper is to outline the process and outcome of an evaluation study of transformed academic library spaces at the Melbourne Burwood Campus using TEALS. In light of changing higher education practices and students learning preferences, Deakin University has been questioning the balance of informal learning spaces and more formal teaching and academic spaces across its campuses. Commissioned by Deakin University Library, TEALS (Tool for the Evaluation of Academic Library Spaces) was developed to evaluate academic library spaces. The Melbourne Burwood Campus library has undergone several phases of refurbishment to create a library environment that is centred around students’ needs and that supports their individual and group learning experiences. In addition, areas of the library yet to be improved will undergo a major redevelopment over the next year. Given this, carrying out an evaluation of the current spaces is timely to ensure that a better understanding of the impact of changes is achieved. The evaluation process involved: a review of architectural plans and space briefing documents; an observational study of spaces; focus groups with students and library staff; and an online survey of Students’ Library Experience. Use of the TEALS space evaluation tool along with an analysis of data collected during the evaluation process have provided significant insights into various dimensions of the quality of new library spaces. The areas of weakness and strength identified in the study will inform the next phase of Deakin University Library space redevelopment.

Crossing the line : collusion or collaboration in university group work?

In both policy and practice, collusion is a perplexing area of academic integrity. Students are expected to learn to work collaboratively in university courses, yet are often required to submit assessment tasks as individuals whilst in group-work situations. This paper discusses the tension between 'collaboration' and 'collusion' in group-work and the consequences for crossing the line. Adopting a theoretical framework from Bourdieu's work (Bourdieu and Passeron, 1971; Bourdieu, 1991) on symbolic power, the notion of legitimate voice and intertextuality, this paper outlines the effects on the academic identities of 17 students found 'guilty' of collusion in one Australian university. In addition, 34 staff involved in formal disciplinary procedures were interviewed. The findings indicate that collusion is a fraught notion and not approached systematically across the university, nor with any degree of confidence by staff or students. The delineation between 'acceptable collaboration' and 'collusion' appears to be founded in shifting sands, with negative attitudes towards collaborative tasks being the main lesson learned by students.

Development of a tool for evaluation of academic library spaces (TEALS) (0242)

The paper provides a brief description of the tool for evaluating the quality and utilisation of academic library spaces (TEALS). Supported by Deakin University Library, TEALS has been developed out of a research project in the School of Architecture and Building, Deakin University, Geelong Waterfront Campus. The tool is intended to establish the setting for evaluation of physical spaces at different phases of development of new academic library spaces and refurbishment of existing ones as well as throughout the life of buildings. The methodological framework of the tool consists of four key elements; establishing Criteria of Quality (CoQ), determining Quality Indicators, evaluating library spaces against QIs and interpreting results for future improvements. The characteristics that distinguish TEALS from existing evaluation models include adopting an approach that focus on people (students, faculty and library staff), acting as a “reflective” and “empowering” tool and being user-friendly, quick and easy to use.

(Un)ethical practices and ethical dilemmas in universities : academic leaders’ perceptions

In this paper we report on the qualitative component of a study that explored middle-level academic leaders’ experiences of (un)ethical practices and ethical dilemmas in their daily work. An electronic survey was distributed to academic leaders from universities across three Australian states. There are three major findings in this study. First, the messy context of universities is providing a fertile ground for ethical dilemmas to flourish. Second, the two main categories of unethical practices identified by participants were academic dishonesty and inappropriate behaviour towards staff and students. Third, the ethical dilemmas that emerged focused on the academic leaders’ strong sense of professional ethics that were in conflict with an ethic of care, supervisors’ directives, and the rules and policies of the organisation.

Evaluation of a training program to assist care staff to better recognize and manage depression among palliative care patients and their families

This study was designed to evaluate the effectiveness of a training program to improve the knowledge, attitudes, and self-efficacy of palliative care staff and thus enable them to better detect and manage depression among palliative care patients and their families. Participants were 90 professional carers who completed a four-session training program. Knowledge, attitudes, self-efficacy, and barriers to working with depressed patients were assessed preintervention, post-intervention, and at a three-month follow-up. The results demonstrated that compared to the control group, the intervention group had improved in all of these areas. Improvements were maintained at the three-month follow-up in all areas except attitudes. The results of this study indicate the importance of training in managing depression among palliative care staff. Booster sessions will likely be needed to ensure that training program gains are maintained.