Hospital to home outreach for malnourished elders (HHOME) : a feasibility pilot

Objectives: Malnutrition is common in older hospitalised patients, and barriers to adequate intake in hospital limit the effectiveness of hospital-based nutrition interventions. This pilot study was undertaken to determine whether nutrition-focussed care at discharge and in the early post-hospital period is feasible and acceptable to patients and carers, and improves nutritional status. Design: Prospective cohort study Setting: Internal medicine wards of a tertiary teaching hospital in Brisbane, Australia Participants: Patients aged 65 and older admitted for at least 3 days, identified as malnourished or at risk of malnutrition using Mini Nutritional Assessment (MNA). Interventions: An interdisciplinary discharge team (specialist discharge planning nurse and accredited practicing dietitian) provided nutrition-focussed education, advice, service coordination and follow-up (home visits and telephone) for 6 weeks following hospitalisation Measurements: Nutritional intake, weight, functional status and MNA were recorded 6 and 12 weeks after discharge. Service intensity and changes to care were noted, and hospital readmissions recorded. Service feedback from patients and carers was sought using a brief questionnaire. Results: 12 participants were enrolled during the 6 week pilot (mean age 82 years, 50% male). All received 1-2 home visits, and 3-8 telephone calls. Four participants had new community services arranged, 4 were commenced on oral nutritional supplements, and 7 were referred to community dietetics services for follow-up. Two participants had a decline in MNA score of more than 10% at 12 week follow-up, while the remainder improved by at least 10%. Individualised care including community service coordination was valued by participants. Conclusion: The proposed model of care for older adults was feasible, acceptable to patients and carers, and associated with improved nutritional status at 12 weeks for most participants. The pilot data will be useful for design of intervention trials.

Front page schools, back page schools : a case study of factors perceived to affect academic performance in five Papua New Guinea secondary schools

Papua New Guinea has reformed its colonial established education system and made huge investments with the help of donors to achieve equal access and quality education for all its citizens. Despite this national aspiration and these policy reforms and investments, secondary schools that enrol grade 9 students who are relatively equal in education ability show huge disparities in their grade 10 academic performances. This study examined perceptions of students, teachers and principals regarding factors affecting the disparity in academic performance in the context of a developing country. The central question for the study is: What are the perceptions of students and teachers of the factors that affect disparities in secondary schools' academic performance? This qualitative case study involved two high and three low academic performing secondary schools in Western Highlands Province of Papua New Guinea. Primary data were collected through focus groups and semi-structured interviews involving 112 participants. Students and teachers are key participants in this study, as it intends to find out the realities of schools, yet they are an under-researched group. A postcolonial and sense of community conceptual framework was developed for the analysis of the participants. perceptions. In addition, scholarship on school effectiveness and equity in education informed the interpretation of the findings. Three themes were evident in participants. views. First, participants expressed their view that differences in academic performance were related to the adequacy and equitability of resources. The inequities in resource inputs led some of them to coin the metaphor of .back page and front page. schools. Second, many expressed the view that deficiencies in implementing bilingual education, given the difficulty of catering for 800 vernacular languages, contribute to poor English proficiency and subsequent poor academic performance. Finally, participants believed that, in order to have a positive school culture, it is necessary for educators to recognise and respect contemporary students. identities, communal/tribal membership and needs. This study has implications for national education policy on resource allocation to address equality and equity, bilingual education and teacher education. Moreover, as the study found that high academic performance in this context is also influenced by intra-school social relationships, these relationships need to be nurtured. When appropriately nurtured, they become an important factor in sustaining quality education for all secondary school students. This thesis has laid the foundations for further research and invites further investigations into policy and implementation of school reforms aimed at improving academic achievement.

Secondary curve behavior in Lenke Type 1C adolescent idiopathic scoliosis after thoracoscopic selective anterior thoracic fusion

Study Design. Analysis of a case series of 24 Lenke 1C adolescent idiopathic scoliosis (AIS) patients receiving selective thoracoscopic anterior scoliosis correction. Objective. To report the behaviour of the compensatory lumbar curve in a group of Lenke IC AIS patients following thoracoscopic anterior scoliosis correction, and to compare the results of this study with previously published data. Summary of Background Data. Several prior studies have reported spontaneous lumbar curve correction for both anterior and posterior selective fusion in Lenke 1C/King-Moe II patients; however to our knowledge no previous studies have reported outcomes of thoracoscopic anterior correction for this curve type. Methods. All AIS patients with a curve classification of Lenke 1C and a minimum of 24 months follow-up were retrieved from a consecutive series of 190 AIS patients who underwent thoracoscopic anterior instrumented fusion. Cobb angles of the major curve, instrumented levels, compensatory lumbar curve, and T5-T12 kyphosis were recorded, as well as coronal spinal balance, T1 tilt angle and shoulder balance. All radiographic parameters were measured before surgery and at 2, 6, 12 and 24 months after surgery. Results. Twenty-four female patients with right thoracic curves had a mean thoracic Cobb angle of 53.0° before surgery, decreasing to 24.9° two years after surgery. The mean lumbar compensatory Cobb angle was 43.5° before surgery, spontaneously correcting to 25.4° two years after surgery, indicating balance between the thoracic and lumbar scoliotic curves. The lumbar correction achieved (41.8%) compares favourably to previous studies. Conclusions. Selective thoracoscopic anterior fusion allows spontaneous lumbar curve correction and achieves coronal balance of main thoracic and compensatory lumbar curves, good cosmesis and patient satisfaction. Correction and balance are maintained 24 months after surgery.

Combined VEGF and PDGF treatment reduces secondary degeneration after spinal cord injury

Trauma to the spinal cord creates an initial physical injury damaging neurons, glia, and blood vessels, which then induces a prolonged inflammatory response, leading to secondary degeneration of spinal cord tissue, and further loss of neurons and glia surrounding the initial site of injury. Angiogenesis is a critical step in tissue repair, but in the injured spinal cord angiogenesis fails; blood vessels formed initially later regress. Stabilizing the angiogenic response is therefore a potential target to improve recovery after spinal cord injury (SCI). Vascular endothelial growth factor (VEGF) can initiate angiogenesis, but cannot sustain blood vessel maturation. Platelet-derived growth factor (PDGF) can promote blood vessel stability and maturation. We therefore investigated a combined application of VEGF and PDGF as treatment for traumatic spinal cord injury, with the aim to reduce secondary degeneration by promotion of angiogenesis. Immediately after hemisection of the spinal cord in the rat we delivered VEGF and PDGF and to the injury site. One and 3 months later the size of the lesion was significantly smaller in the treated group compared to controls, and there was significantly reduced gliosis surrounding the lesion. There was no significant effect of the treatment on blood vessel density, although there was a significant reduction in the numbers of macrophages/microglia surrounding the lesion, and a shift in the distribution of morphological and immunological phenotypes of these inflammatory cells. VEGF and PDGF delivered singly exacerbated secondary degeneration, increasing the size of the lesion cavity. These results demonstrate a novel therapeutic intervention for SCI, and reveal an unanticipated synergy for these growth factors whereby they modulated inflammatory processes and created a microenvironment conducive to axon preservation/sprouting.

Does charity begin and end at home for tax exemptions?

Charitable organisations have remained exempt from income tax in Australia since the first comprehensive state income tax legislation in 18841 through to the current Income Tax Assessment Act 1977. The charitable exemption was also part of the English income tax legislation from its inception in 1799. The Federal Treasurer has released exposure draft legislation which seeks to remove taxation exemptions from some tax exempt organisations that perform any of their activities outside Australia or make trust distributions overseas. The proposed legislation is in response to alleged tax avoidance arrangements which involve tax exempt organisations and charitable trusts. The paper begins by describing the current charity tax exemption provisions under the Income Tax Assessment Act (ITAA). It then turns to tracing the background policy history of the amendments which appear to be at odds with the form and intent of the proposed provisions. The proposed amendments and their practical consequences are then closely scrutinised and found wanting in a number of respects. Alternative strategies are suggested to arrive at an equitable solution to the avoidance mischief.

Abundance of introduced species at home predicts abundance away in herbaceous communities

Many ecosystems worldwide are dominated by introduced plant species, leading to loss of biodiversity and ecosystem function. A common but rarely tested assumption is that these plants are more abundant in introduced vs. native communities, because ecological or evolutionary-based shifts in populations underlie invasion success. Here, data for 26 herbaceous species at 39 sites, within eight countries, revealed that species abundances were similar at native (home) and introduced (away) sites – grass species were generally abundant home and away, while forbs were low in abundance, but more abundant at home. Sites with six or more of these species had similar community abundance hierarchies, suggesting that suites of introduced species are assembling similarly on different continents. Overall, we found that substantial changes to populations are not necessarily a pre-condition for invasion success and that increases in species abundance are unusual. Instead, abundance at home predicts abundance away, a potentially useful additional criterion for biosecurity programmes.

Leadership practices of Kuwaiti Secondary School Principals for embedding ICT

Globalisation and the emergence of knowledge-based economies have forced many countries to reform their education system. The enhancement of human capital to meet modern day demands of a knowledge economy, and equip the new generation with the capacity to meet the challenges of the 21st Century has become a priority. This change is particularly necessary in economies typical of countries, such as Kuwait, which have been dependent on the exploitation of non-renewable natural resources. Transiting from a resource-based economy to an economy based on knowledge and intellectual skills poses a key challenge for an education system. Significant in the development of this new economy has been the expansion of Information Communication Technology (ICT). In education, in particular, ICT is a tool for transforming the education setting. However, transformation is only successful where there are effective change management strategies and appropriate leadership. At the school level, rapid changes have affected the role that principals take particularly in relation to leading the change process. Therefore, this study investigated the leadership practices of school principals for embedding ICT into schools. The case study assessed two Kuwaiti secondary schools; both schools had well established ICT programs. The mode of data collection used a mixed-methods design, to address the purpose of the study, namely, to examine the leadership practices of school principals when managing the change processes associated with embedding ICT in the context of Kuwait. A theoretical model of principal leadership, developed, from the literature, documented and analysed the practices of the respective school principals. The study used the following five data sources: (a) face to face interviews (with each school principal), and two focus group interviews (with five teachers and five students, from each school); (b) school documents (related to the implementation and embedding of ICT); (c) one survey (of all teachers in each school); (d) an open-ended questionnaire (of participating principals and teachers); and (e) the observation of ICT activities (PD ICT activities and instruction meetings). The study revealed a range of strategies used by the principals and aligned with the theoretical perspective. However, these strategies needed to be refined and selectively used to fit the Kuwait context, both culturally and organisationally. The principals of Schools A and B employed three key strategies to maximise the impact on the teaching staff incorporating ICT into their teaching and learning practices. These strategies were: (a) encouragement for teaching staff to implement ICT in their teaching; (b) support to meet the material and human needs of teaching staff using ICT; and (c) provision of instructions and guidance for teaching staff in how and why such behaviours and practices should be performed. The strategies provided the basic leadership practices required to construct a successful ICT embedded implementation process. Hence, a revised model of leadership that has applicability in the adoption of ICT in Kuwait was developed. The findings provide a better understanding of how a school principal’s leadership practices impact upon the ICT embedding process. Hence, the outcome of this study informs emerging countries, which are also undergoing major change related to ICT, for example, other members of the Cooperation Council for the Arab States of the Gulf. From an educational perspective, this knowledge has the potential to support ICT-based learning environments that will help educational practitioners to effectively integrate ICT into teaching and learning that will facilitate students’ ICT engagement, and prepare them for the ICT development challenges that are associated with the new economy; this is achieved by increasing students’ knowledge and performance. Further, the study offers practical strategies that have been shown to work for school principals leading ICT implementation in Kuwait. These strategies include how to deal with the shortage in schools’ budgets, and the promotion of the ICT vision, as well as developing approaches to build collaborative culture in the schools.

A controlled, longitudinal study of home visits compared to telephone contacts to prevent early childhood caries

Background Home visits (HV) provide excellent opportunities for health promotion. Aim This longitudinal study compared the effects of HV and telephone contacts (TC) in preventing early childhood caries (ECC) and colonisation of mutans streptococci (MS) and lactobacilli (LB) from 0 to 24 months. Design A total of 325 children were recruited from community health centres at mean age of 42 days, and randomly assigned to receive either HV or TC. A total of 188 children completed three, 6 monthly HV, and another 58 had three, 6 monthly TC. An additional 40 age-matched children from childcare facilities served as reference controls (RC). At 24 months, all groups were examined at a community dental clinic. Results At 24 months, three HV children of 188 (1.5%) had caries, compared to four TC of 58 (6.8%) and nine RC of 40 (22.5%) (P < 0.001 for HV versus RC; P = 0.05 for HV versus TC and P = 0.03 for TC versus RC). There were also more children with MS in the TC (47%) and RC (35%) compared to HV (28%) group (P = 0.01 and P = 0.02). Conclusions Home visits and telephone contacts conducted 6 monthly from birth are effective in reducing ECC prevalence by 24 months.

Don's Party and the AV Jennings type 15 home

Australian housing underwent a watershed when 1960s mass-produced houses slowly started subscribing to a new aesthetic of continuous living spaces, known as the ‘open plan’ home. This created a new landscape for Australian playwrights to observe and explore in their work when representing domesticity on the stage. Instead of representing a single room of the house on the stage, plays such as ‘Don’s Party’, started to work with a number of openly connected spaces bound by doorways to private sections of the house or to specific outdoor areas. In representing this dialectic between interior and the exterior, private and public spaces in the home, the continuous spaces of the AV Jennings house in ‘Don’s Party’ acted to blur these conditions creating an outer interior. These connected spaces became the place for an outward performance on the family’s interiority, while simultaneously presenting a boundary to an inner interior in the offstage spaces of the home. This paper focuses on the play 'Don's Party' by David Williamson and how the spatial arrangements of the AV Jennings home, in which it was set, influenced the playwright. The research includes a textual analysis of the play, biographical research and interviews with the playwright alongside an analysis of the spatial arrangements of AV Jennings houses.

Young people whose parents are separated or divorced: A case for researching their experiences at the intersection of home and school

Background: Young people whose parents are separated or divorced form a significant and increasing proportion of young people who attend school. To date, empirical research with young people whose parents are separated or divorced has tended to focus on either their household context, or their school context, rather than on both contexts together. This paper redresses this singular focus by examining the intersection of the experiences of young people at both home and school. Purpose: The paper seeks to map the empirical evidence of young people's home and school experiences as they move between households and schools. Sources of evidence: The paper provides a narrative review of the literature from the 1990s to the present, locating Australian research within an international context. The review is framed by four main questions. What is the impact upon young people of the family transitions that occur when parents separate or divorce? What is the everyday impact upon young people of moving between one household and another? What does the research reveal regarding educational, social and emotional outcomes for this group? What does the research reveal regarding their school experiences? Main argument: The review reveals a paucity of Australian research at the intersection of home and school. It shows that, while young people from these contexts form a growing proportion of the school population, there is little empirical evidence of what is actually occurring in their everyday lives. The review reveals the importance of researching from the perspectives of the young people themselves. Conclusions: Evidence provided in the paper shows that many young people whose parents separate or divorce are affected socially, emotionally and educationally. Such evidence points to the need for research into the everyday experiences of the young people at school, in order to identify, from their perspective, how schools can better cater for these young people and their families.

Broadening horizons : an emerging research agenda modelling design led innovation across secondary education

A re-examination of design education at all levels is needed to ensure global economic competitiveness and social and environmental sustainment. This paper presents an emerging research agenda modelling design led innovation approaches from the business sector to secondary education curriculum. To do this, a review of literature is provided and current knowledge gaps surrounding design education are detailed. A regional secondary school design immersion program is outlined as a future research case study using action research. A framework and recommendations for developing and delivering pedagogical approaches for 21st century skill outcomes in secondary education are briefly introduced and future research objectives are overviewed and discussed.

An integrated approach to professional development in secondary schools

Following the implementation of the National Professional Standards for Teachers, all teachers in Australia will be required to undertake 30 hours per year of professional development (PD) to maintain their registration. However, defining what constitutes effective PD is complex and often contested. This paper looks at a case study in Queensland, Australia, where a high school worked collaboratively with a university lecturer to deliver effective whole-school professional development. The lecturer acted as an external change agent, working closely with the principal and staff to build a relationship of trust and to develop a strategy for the delivery of PD on-site. This case highlights how partnerships between teachers and teacher educators combined with a willing school leader can provide positive opportunities for collaborative, sustainable, professional growth and learning.

Residential property investment : assessing home ownership long term viability

Home purchase and ownership is seen by the majority of Australians as the basis for a sound investment strategy and to seciure their long term retirement goals. Although home ownership rates in Australia are in excess of 65% of the population, there have been doubts raised as to the effectiveness of purchasing a house as the main source of retirement income. The main issue with this approach is that the house has to be sold to gain access to these funds or the owners have to take out a reverse mortgage to access the capital tied up in their home, which can be more expensive than selling. This paper will carryout a detailed analysis of a number of investment options to determine the effectiveness of home purchase as a long term investment vehicle. This study has found that the long term investment in equities or managed superannuation funds can provide a greater retirement income than the purchase of a residential property for owner occupation

Ageing out of place: health and well-being needs and access to home and aged care services for recently arrived older refugees in Melbourne, Australia

Recently arrived older refugees in resettlement countries are a particularly vulnerable population who face many risks to their health and well-being, and many challenges in accessing services.This paper reports on a project undertaken in Victoria,Australia to explore the needs of older people from 14 recently arrived refugee communities, and the barriers to their receiving health and aged care. Findings from consultations with community workers and service providers highlight the key issues of isolation, family conflict and mental illness affecting older refugees, and point to ways in which policy-makers and service providers can better respond to these small but deserving communities.

Fish out of water : refugee and international students in mainstream Australian schools

In this paper, the authors combine Pierre Bourdieu’s concept of hysteresis (the ‘fish out of water’ experience) with the discourse historical approach to critical discourse analysis (CDA) as a theoretical and analytical framework through which they examine specific moments in the schooling experiences of one refugee student and one international student, both enrolled in post-compulsory education in Australian mainstream secondary schools. We examine specific moments – as narrated by these students during interviews – in which these students can be described as ‘fish out of water’. As such, this paper takes up the concerns of researchers who call for an examination of the lived geographies and the everyday lives of individual students in mainstream schools. We find that our students’ habitus, conditioned by their previous schooling experiences in their home countries, did not match their new Australian schools, resulting in frustration with, and alienation from, their mainstream schools. However, we also note that schools, too, need to adapt and adjust their habitus to the new multicultural world, in which there are international and refugee students among their usual cohort of mainstream students.