Promoting healthy, productive ageing: plan early, plan well

This article reports that the population bulge of the post-war baby boom, increased life expectancy and declining birth rates are forcing governments to address the changing demographic of an "older" society. Successful ageing revolves around optimum health and well-being, active support networks and engagement in the community, and personal autonomy over life choices. Despite the social and financial advantages of work, many people look forward to retirement and begin retirement planning in the latter part of their working life.

Cultural diversity and mental health : the relationship between leisure experiences and wellbeing in an ageing Italian community in Australia

One of the population health implications for Australia’s ageing population is that a larger proportion of the Australian community will be retired and have more time for leisure pursuits. Meaningful leisure activities for this group are thought to be a factor in promoting positive mental health. However, a search of health literature revealed a paucity of research on how older adults make use of their leisure time, what meaning these pursuits have to them, and whether their chosen leisure activities are health enhancing and promote wellbeing. Australia’s population is diverse with many cultures represented. As the population ages, mental health workers will be called upon to provide culturally-appropriate mental health services to clients from a range of ethnic groups. Literature on how people of culturally diverse backgrounds understand leisure activities is also limited. This paper reports on a study carried out in an Italian community in a large regional centre. The participants were selected based on the following criteria; aged 65 years and over, born in Italy, independently living in the community, ambulant, and retired from paid workforce. This study explored how a well-elderly group from an ethnic community derived meaning from their leisure activities and how this impacted on their mental health. Establishing the relationship between leisure and mental health in an ageing ethnic community is important because it sheds light on potential intervention strategies that can be used to maintain the mental health of people living independently in the community. Participants were interviewed using semi-structured questions about their perceptions of leisure, the meanings they derived from these activities, and their perceived impact of these activities on their health. Participant observation was also used to add trustworthiness to the data. Themes arising from the interviews and participant observation will be related to the participants’ sense of health. Results also revealed how older Italians engaged in leisure activities. Implications of the research findings will be directed towards mental health practice with older ethnic clients in community settings. The promotion of healthy lifestyles and positive mental health for Australia’s ageing population will also be discussed.

Responding to the ageing profile of emergency department patients

Background
Older people with acute superimposed on chronic health problems are becoming a core aspect of emergency department (ED) caseload. This project explored the ED experience from the perspective of older patients and their carers.

Method
A convenience sample of thirty participants was recruited across three participating EDs: tw o metropolitan and one regional. The project utilised two approaches to data collection: 1) an observation approach where a project officer observed participants from the time of ED presentation until discharge, or for up to six hours; and 2) a subsequent interview was conducted with the participant and their carer within a week of the ED presentation. Data from both sources were integrated, and independently thematically analysed by two members of the team.

Results
Thirty participants aged over 65 were recruited. Their average age was 77.1 (sd=6.7) years, 59% w ere female, and 74% were triage category 1- 3 (indicating moderate/high acuity). Participants spent on average 7 hours 47 minutes in the ED, with 50% discharged home, 43% admitted to general wards or MAPU, and 7% discharged to residential care/hospice. Key themes in the factors influencing the patient experience and examples of quality care were identified, along with opportunities to improve the capacity for EDs to be “older person friendly”, and “person-centred.” Challenges include improving the effectiveness of communication between staff and patients/carers (including issues around people from culturally and linguistically diverse backgrounds), availability of allied health professionals to assist with discharge planning, and a tendency for older people not to seek ED care until the health problem was severe. Patient exemplars highlight key themes.

Discussion and implications
Results of the project highlight positive aspects of emergency department care for older people and inform targets for improvement strategies. These can be used to drive ongoing improvements in care for older people presenting to EDs.

Factors that predict work ability : incorporating a measure of organisational values towards ageing

This research conducted in an Australian public sector organisation aimed to identify the main factors that predict work ability for employees. According to Ilmarinen's (1999) model of work ability, an individual's work ability is influenced by their general health, attitudes, values and motivation interacting with workplace and other environmental demands. However what is unknown is the influence of value incongruence (i.e. the lack of fit between individual and organisational values), particularly when that incongruence results in age discrimination. This is important in an Australian context where youth and symbols of youth are over-valued in business environments and where older workers themselves perceive age discrimination as the single most important cause of early exit from the labour force.

109 participants completed a survey about work ability. Differences between work ability and health were not found between older and younger workers suggesting that strategies for improving work ability could be targeted at all employees rather than just older employees. However there were significant differences found between older and younger workers on reasons that would influence employees to stay longer in the organisation. Older workers tended to be more influenced by the provision of less demanding work, and positive attitudes towards older workers. Younger workers tended to be more influenced by opportunities to be employed in another section of the organisation, skills training opportunities and career advancement opportunities.

Results from hierarchical regression analyses suggested that good physical and mental health, and low occupational stress related to workplace culture were significant predictors of increased work ability. Results also suggested that occupational stress is likely to decrease with: high work ability and work satisfaction; and high value congruence. Implications for wellbeing programs to include the development of targeted organisational values are discussed.

Foraging trip strategies and habitat use during late pup rearing by lactating Australian fur seals

Australian fur seals (Arctocephalus pusillus doriferus) are the most conspicuous and abundant marine mammal in shelf waters of south-eastern Australia. To successfully rear offspring, the females must encounter sufficient prey on each foraging trip out of a central place for periods up to11 months each year. We investigated foraging trip strategies and habitat use by the females in three winter–spring periods, 2001–03, from four colonies that span the species’ latitudinal range and contribute 80% of pup production. Trip durations of 37 females averaged 6.1±0.5 (s.e.) days, although >90% of the seal’s time at sea was spent <150 km travel (<2 days) away. Most females exhibited strong fidelities to individually preferred hotspots Females from colonies adjacent to productive shelf-edge waters generally had shorter trips, had smaller ranges, foraged closer to colonies and exhibited less diversity in trip strategies than did those from colonies more distant from a shelf-edge. From a management perspective, there was minimal overlap (<1%) between where females foraged and a system of marine reserves established in 2007, suggesting that habitats visited by lactating Australian fur seals currently receive minimal legislative protection

Self-reported medication side effects in an older cohort living independently in the community - the Melbourne Longitudinal Study on Health Ageing (MELSHA) : cross-sectional analysis of prevalence and risk factors

Background Medication side effects are an important cause of morbidity, mortality and costs in older people. The aim of our study was to examine prevalence and risk factors for self-reported medication side effects in an older cohort living independently in the community.

Methods The Melbourne Longitudinal Study on Healthy Ageing (MELSHA), collected information on those aged 65 years or older living independently in the community and commenced in 1994. Data on medication side effects was collected from the baseline cohort (n = 1000) in face-to-face baseline interviews in 1994 and analysed as cross-sectional data. Risk factors examined were: socio-demographics, health status and medical conditions; medication use and health service factors. Analysis included univariate logistic regression to estimate unadjusted risk and multivariate logistic regression analysis to assess confounding and estimate adjusted risk.

Results Self-reported medication side effects were reported by approximately 6.7% (67/1000) of the entire baseline MELSHA cohort, and by 8.5% (65/761) of those on medication. Identified risk factors were increased education level, co-morbidities and health service factors including recency of visiting the pharmacist, attending younger doctors, and their doctor's awareness of their medications. The greatest increase in risk for medication side effects was associated with liver problems and their doctor's awareness of their medications. Aging and gender were not risk factors.

Conclusion Prevalence of self-reported medication side effects was comparable with that reported in adults attending General Practices in a primary care setting in Australia. The prevalence and identified risk factors provide further insight and opportunity to develop strategies to address the problem of medication side effects in older people living independently in the community setting.

Reproduction and ageing of Australian holocephalans and white-fin swell shark

The holocephalans are a slow growing, long lived group with a conservative life history strategy and require similarly conservative fishery management strategies to ensure their sustainable exploitation. White-fin swell shark are relatively short lived, highly fecund and likely to be more capable of withstanding intensive fishing.

LC-REHAB : randomised trial assessing the effect of a new patient education method - learning and coping strategies - in cardiac rehabilitation

Due to improved treatments and ageing population, many countries now report increasing prevalence in rates of ischemic heart disease and heart failure. Cardiac rehabilitation has potential to reduce morbidity and mortality, but not all patients complete. In light of favourable effects of cardiac rehabilitation it is important to develop patient education methods which can enhance adherence to this effective program. The LC-REHAB study aims to compare the effect of a new patient education strategy in cardiac rehabilitation called 'learning and coping' to that of standard care. Further, this paper aims to describe the theoretical basis and details of this intervention.

Urban agriculture up-scaled: economically and socially productive public green space

'Space is fundamental in any form of commnunal Life; space is fundamental in any exercise of power' (Foucault & Rabinow, 1984: 252). Public green space has the potential to provide one our last remaining free sources of access to open land, clean air, vegetation, water and soil within the urban realm. In most developed countries, this space - due to complex, interconnected legacies of enclosure, privatisation, population growth, urbanisation and 'modernisation' - typically exists as controlled, contrived, scenic picturesque landscapes, unavailable for forms ofcivic, productive and generative activities at scale, such as public urban agriculture. Narrow assessment of green space's on-going financial and maintenance costs fail to recognise wider gains (such as physical and psychological wellness, increased property value , decreased crime rates) (Maller, 2002· Woolley, 2004; Sherer, 2006) and despite attempts, studies that present financial benefits of green spaces have not yet managed to stem the tide of budget cut and reduced spending. Perhaps more importantly, income-generating strategies within public green spaces have not been sufficiently explored. Such approaches could help to develop more convincing arguments analogous with the measurement metrics and quantitative language threatening green space's optimisation and survival. By 'up-scaling' public green space's productive capacity within an ethical framework, we have the potential to greatly enhance social and environmental performance - shifting the existing paradigm from passive to active, consumptive to generative and centralised to collective.