Multi-attribute preference modelling and regional land-use planning

Forest management policy decisions are complex due to the multiple-use nature of goods and services from forests, difficulty in monetary valuation of ecological services and the involvement of a large number of stakeholders. Multi-attribute decision techniques can be used to synthesise stakeholder preferences related to regional forest planning because it can accommodate conflicting, multidimensional, incommensurable and incomparable objectives. The objective of this paper is to examine how the Analytical Hierarchy Process (AHP) can be used to incorporate stakeholder preferences in determining optimal forest land-use choices. The Australian Regional Forest Agreement Programme is taken as an illustrative case for the analysis. The results show that the AHP can formalise public participation in decision making and increase the transparency and the credibility of the process.

Dementia in older people admitted to hospital: a regional multi-hospital observational study of prevalence, associations and case recognition

BACKGROUND: previous studies have indicated a prevalence of dementia in older admissions of ∼42% in a single London teaching hospital, and 21% in four Queensland hospitals. However, there is a lack of published data from any European country on the prevalence of dementia across hospitals and between patient groups. OBJECTIVE: to determine the prevalence and associations of dementia in older patients admitted to acute hospitals in Ireland. METHODS: six hundred and six patients aged ≥70 years were recruited on admission to six hospitals in Cork County. Screening consisted of Standardised Mini-Mental State Examination (SMMSE); patients with scores <27/30 had further assessment with the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Final expert diagnosis was based on SMMSE, IQCODE and relevant medical and demographic history. Patients were screened for delirium and depression, and assessed for co-morbidity, functional ability and nutritional status. RESULTS: of 598 older patients admitted to acute hospitals, 25% overall had dementia; with 29% in public hospitals. Prevalence varied between hospitals (P < 0.001); most common in rural hospitals and acute medical admissions. Only 35.6% of patients with dementia had a previous diagnosis. Patients with dementia were older and frailer, with higher co-morbidity, malnutrition and lower functional status (P < 0.001). Delirium was commonly superimposed on dementia (57%) on admission. CONCLUSION: dementia is common in older people admitted to acute hospitals, particularly in acute medical admissions, and rural hospitals, where services may be less available. Most dementia is not previously diagnosed, emphasising the necessity for cognitive assessment in older people on presentation to hospital.

The consequences of land use change on nutrient exports: a regional scale assessment in south-west Victoria, Australia

Estimation of nutrient load production based on multi-temporal remotely sensed land use data for the Glenelg–Hopkins region in south-west Victoria, Australia, is discussed. Changes in land use were mapped using archived Landsat data and computerised classification techniques. Land use change has been rapid in recent history with 16% of the region transformed in the last 22 years. Total nitrogen and phosphorus loads were estimated using an export coefficient model. The analysis demonstrates an increase in modelled nitrogen and phosphorus loadings from 1980 to 2002. Whilst such increases were suspected from past anecdotal and ad-hoc evidence, our modelling estimated the magnitude of such increases and thus demonstrated the enormous potential of using remote sensing and GIS for monitoring regional scale environmental processes.

A rural model for delivering regional continuing nurse education by videoconference : a pilot project

Background : The South West Alliance of Rural Health (SWARH) is an alliance of 33 health care agencies scattered across South West Victoria over a total area of approximately 46 000 square kilometres. SWARH was established to develop and install information technology (IT) infrastructure, hardware and software for all acute public hospitals in the region. The Rural Intercampus Learning Environment Project (March 2003-March 2004) piloted the use of the SWARH regional area IT network to deliver a program of continuing education to Division 1 registered nurses, utilising the expertise of local health professionals. The study was funded by the Department of Human Services, Victoria.

Aims & rationale/Objectives : Establish partnerships for multi-site delivery of programs.
Develop existing educational programs and resources for video and intranet delivery (including IT training and change management).
Collaboratively deliver educational programs utilising SWARHnet to six rural sites.
Explore issues related to the use of the technology in continuing education for rural nurses and the implications for practice.

Methods : Key informant interviews, paper-based audits, and focus groups informed the development of the schedule of the program. Session participants completed a 2-page evaluation questionnaire.

Principal findings : Participants must own the process.
Videoconferencing should be considered an adjunct to traditional education programs.
Videoconferencing most suitable for short education sessions as opposed to full-day workshops.
IT problems are unpredictable and frustrating for all concerned.
IT awareness/training of staff is essential.

Implications : The project proposes a model for coordinating and delivering regional continuing education which has been shown to improve access to education programs across multiple sites. It provides a sustainable organisational framework for the program, which could be applied in continuing professional education programs of other rural health professions, such as dentistry, medicine, allied health and pharmacy.

Presentation type : Poster

Evaluation of housing developments for sustainability using a multi-criteria approach

New housing developments in Australia, particularly on Greenfield sites on the edge of existing urban centres, need to be sustainable in environmental and social terms if long term problems are to be avoided. Sustainability is multi-dimensional and existing analyses have been found to be inadequate in assessing housing developments holistically. This paper describes research which has used five criteria (energy use, resource use, neighbourhood character, neighbourhood connectivity and diversity), representing 31 indicators, to assess three housing precincts of a regional city in southern Australia. The method has been found to produce useful assessments of sustainability. The method has the potential to inform future housing developments and to be used to improve existing suburbs.

Patterns and perceptions of physical activity and sedentary time in male transport drivers working in regional Australia

 Abstract

Objective: To objectively measure physical activity (PA) patterns and sedentary time, and explore perceptions of workplace PA opportunities in regional male transport workers.

Methods: A multi-method study involving 28 drivers (52.4±9.69years) working at a bus company in South-East Queensland, Australia. PA was measured using accelerometers (n=23) to determine the proportion of time spent in sedentary (<150 cpm), light (151–2,689 cpm) and moderate+ (≥2,690 cpm) intensity categories. Paired sample t-tests were used to evaluate differences between categories on a workday/off-workday (n=16), and during work/non-work time (n=15). Interviews were conducted with 28 drivers and six managers to explore perceptions and ideas relating to workplace PA opportunities.

Results: Sedentary time was significantly higher on off-work (64% of wear time) than work (52%) days (p<0.05), while the opposite was the case for light intensity time (off-workday=33%; workday=44%; p<0.05). On workdays, sedentary time was significantly lower when employees were working (44%) than when not working (60%; p<0.05). No significant differences were found for time spent in moderate+ PA. Driver perceptions indicated that PA opportunities (walking club and corporate gym membership) were being adopted by some drivers. However, at this depot, perceived health issues and organisational barriers (shift work and irregular driving routines), tended to preclude some drivers from engaging with these opportunities.

Conclusions: Findings contest the notion that a sedentary occupation such as driving necessitates an inactive work environment.

Implications: This research informs ongoing intervention efforts to target inactive drivers who are struggling to take advantage of existing workplace-related PA opportunities.

(1)H-NMR analysis of the human urinary metabolome in response to an 18-month multi-component exercise program and calcium-vitamin-D3 supplementation in older men

The musculoskeletal benefits of calcium and vitamin-D3 supplementation and exercise have been extensively studied, but the effect on metabolism remains contentious. Urine samples were analyzed by (1)H-NMR spectroscopy from participants recruited for an 18-month, randomized controlled trial of a multi-component exercise program and calcium and vitamin-D3 fortified milk consumption. It was shown previously that no increase in musculoskeletal composition was observed for participants assigned to the calcium and vitamin-D3 intervention, but exercise resulted in increased bone mineral density, total lean body mass, and muscle strength. Retrospective metabolomics analysis of urine samples from patients involved in this study revealed no distinct changes in the urinary metabolome in response to the calcium and vitamin-D3 intervention, but significant changes followed the exercise intervention, notably a reduction in creatinine and an increase in choline, guanidinoacetate, and hypoxanthine (p < 0.001, fold change > 1.5). These metabolites are intrinsically involved in anaerobic ATP synthesis, intracellular buffering, and methyl-balance regulation. The exercise intervention had a marked effect on the urine metabolome and markers of muscle turnover but none of these metabolites were obvious markers of bone turnover. Measurement of specific urinary exercise biomarkers may provide a basis for monitoring performance and metabolic response to exercise regimes.

Effects of a community-based salt reduction program in a regional Australian population

BACKGROUND: Salt reduction is a public health priority but there are few studies testing the efficacy of plausible salt reduction programs.

METHODS: A multi-faceted, community-based salt reduction program using the Communication for Behavioral Impact framework was implemented in Lithgow, Australia. Single 24-h urine samples were obtained from 419 individuals at baseline (2011) and from 572 at follow-up (2014). Information about knowledge and behaviors relating to salt was also collected.

RESULTS: Survey participants were on average 56 years old and 58 % female. Mean salt intake estimated from 24-h urine samples fell from 8.8 g/day (SD = 3.6 g/day) in 2011 to 8.0 (3.6) g/day in 2014 (-0.80, 95 % confidence interval -1.2 to -0.3;p < 0.001). There were significant increases in the proportion of participants that knew the recommended upper limit of salt intake (18 % vs. 29 %; p < 0.001), knew the importance of salt reduction (64 % vs. 78 %; p < 0.001) and reported changing their behaviors to reduce their salt intake by using spices (5 % vs. 28 %; p < 0.001) and avoiding eating out (21 % vs. 34 %; p < 0.001). However, the proportions that checked food labels (30 % vs. 25 %; p = 0.02) fell, as did the numbers avoiding processed foods (44 % vs. 35 %; p = 0.006). Twenty-six percent reported using salt substitute at the end of the intervention period and 90 % had heard about the program. Findings were robust to multivariable adjustment.

CONCLUSIONS: Implementation of this multi-faceted community-based program was associated with a ~10 % reduction in salt consumption in an Australian regional town. These findings highlight the potential of well-designed health promotion programs to compliment other population-based strategies to bring about much-needed reductions in salt consumption.