Key facilitators and barriers to quality of life in residential aged care : the role of design

Australia is undergoing a critical demographic transition: the population is ageing. By 2050, one in four Australians will be older than 65 years and by 2031, the number of older Australians requiring residential aged care will increase 63%, to 1.4 million (ABS, 2005). In anticipation of this global demographic transition, the World Health Organisation has advocated ‘active ageing’, identifying health, participation and security as the three key factors that enhance quality of life for people as they age (WHO, 2002). While there is considerable discussion and acceptance of active ageing principles, little is known about the experience of ‘active ageing’ for older Australians who live in Residential Aged Care Facilities (RACF). This research addresses this knowledge gap by exploring the key facilitators and barriers to quality of life and active ageing in aged care from the perspective of aged care residents (n=12). To do this, the project documented the initial expectations and daily life experience of new residents living in a RACF over a one-year period. Combined with in-depth interviews and surveys, the project utilised Photovoice methodology - where participants used photography to record their lived experiences. The initial findings suggest satisfaction with living in aged care centers around five key themes; resident’s mental attitude to living in aged care, forming positive peer and staff relationships, self-determination and maintaining independence, opportunities to participate in interesting activities, and living in a safe and comfortable physical environment. This paper reports on the last of these five key themes, focusing on the role of design in facilitating quality of life, specifically: “living within these walls” – safety, comfort and the physical environment.

Mastery motivation in children with intellectual disability : Is there evidence for a Down syndrome behavioural phenotype?

The main purpose of the current study was to provide empirical evidence to support or refute assumptions of phenotypic deficits in motivation for children with Down syndrome. Children with moderate intellectual disability associated with etiologies other than Down syndrome were recruited in an extension of a previous study that involved children with Down syndrome and typically developing children. The participants were 29 children with moderate intellectual disability and 33 children with Down syndrome who were matched on mental age to 33 typically developing children, aged 3 to 8 years. Mastery motivation was assessed on task measures of curiosity, preference for challenge, and persistence, as well as parental reports. There were no significant group differences on the mastery motivation tasks. Parental ratings of mastery motivation differed, with typically developing children generally being rated more highly than each of the disability groups. The view that motivational deficits are part of the Down syndrome behavioural phenotype was not supported.

Motivation in children with intellectual disabilities

This article addresses the questions of whether there are motivational deficits in children with intellectual disabilities, whether those with Down syndrome are more likely to display motivational deficits, and how motivation might be supported. The available literature that has examined motivation in children with intellectual disabilities was considered and integrated to address the questions outlined above. There is little published research on this vital topic. Reports on motivational problems differ depending upon the method of data collection. Observational studies using structured tasks generally reveal no differences between children with intellectual disabilities and typically developing children matched for mental age. When reports of parents or teachers are used, children with intellectual disabilities appear to have deficits in motivation. No evidence was found for a particular deficit in children with Down syndrome. The results of this review challenge the perception that children with intellectual disabilities will generally have motivational problems, although it is clear that motivation is a complex construct, not easily examined in those with intellectual disabilities. Strategies for addressing problems and for maintaining motivation, based on theory and evidence, are provided. These strategies are applicable across a range of settings including the home, school, and more adult-oriented services.

Barriers to sustainable economic development : the Dallas–Fort Worth experience

This article examines the scope of existing economic development activity and the motivations and perceptions of practitioners to shed light on the barriers to sustainable practice. In contrast to related fields like urban planning, the economic development literature has minimally examined how practitioners think about sustainable development and the extent to which sustainable development principles are adopted in practice. This omission is significant because economic development policies can have a notable impact on the sustainable development goals of environmental protection and social equity alongside economic growth. To capture the extent to which economic developers engage in sustainable development and the barriers that practitioners face, we study fifteen cities in the Dallas–Fort Worth region. We find that six key barriers – a conventional economic development mindset, incentive-based practice, a lack of resources, ad hoc planning, inter-regional competition, and a lack of coordinated regional planning – impede sustainable economic development in the region.

Effects of intrinsic and extrinsic motivation on user-generated content

User-generated content where content is created and shared among consumers is of key importance to marketers. This study investigates consumer intrinsic and extrinsic motivation to understand why people create user-generated branded video content. Specifically, we examine the role of altruism (individual difference – intrinsic motivation), social benefits (extrinsic reward), and economic incentives (extrinsic reward) on intentions to create user-generated content. Results show that extrinsic rewards (economic incentives) result in more positive intentions to create user-generated content than intrinsic motivations. However, an effect for altruism is also evident revealing that high altruism consumers are more likely to create positive user-generated content. The implication of these findings is that marketers wanting to encourage user-generated content about their brands should target high altruism consumers and offer economic incentives for content creation.

Beyond the barriers : road construction safety issues from the office and the roadside

Conceptually, the management of safety at roadworks can be seen in a three level framework. At the regulatory level, roadworks operate at the interface between the work environment, governed by workplace health and safety regulations, and the road environment, which is subject to road traffic regulations and practices. At the organizational level, national, state and local governments plan and purchase road construction and maintenance which are then delivered in-house or tendered out to large construction companies who often subcontract multiple smaller companies to supply services and labor. At the operational level, roadworks are difficult to isolate from the general public, hindering effective occupational health and safety controls. This study, from the State of Queensland, Australia, examines how well this tripartite framework functions. It includes reviews of organizational policy and procedures documents; interviews with 24 subject matter experts from various road construction and maintenance organizations, and on-site interviews with 66 road construction personnel. The study identified several factors influencing the translation of safety policies into practice including the cost of safety measures in the context of competitive tendering, lack of firm evidence of the effectiveness of safety measures, and pressures to minimize disruption to the travelling public.

Radiation therapist peer review: Raising the bar on quality and safety in radiation oncology

Purpose An emerging developmental tool to help radiation therapists achieve better outcomes is 'peer review'. This review of the current literature summarises the challenges and benefits of peer review in both individual and departmental practice. Discussion There is compelling evidence supporting peer review implementation at both individual and department level in many professions. Implementing peer review requires that radiation therapists and other radiation oncology professionals embrace a culture that supports safety. Peer review can identify trends and barriers associated with quality radiotherapy and share best practice or recommend changes accordingly. Support for peer review must come from pre-registration educational systems as well as clinical managers. Continuing professional development in the workplace is nurtured by peer review of radiotherapy practice and an aptitude for this should be viewed as important to the profession as technical and clinical skills. Conclusion It is clear that peer review has the potential to facilitate reflective practice, improve staff motivation and help foster a culture of quality and safety in radiation oncology. To drive the issues of quality and safety a step further radiation therapists need to accept the challenge of adopting peer review methods in day-to-day practice.

Do children and adolescents with Down syndrome have deficits in motivation?

There appears to be a general acceptance that individuals with intellectual disability (ID) have deficits in motivation. Yet research with infants and young children has usually identified few differences in motivation for children with ID compared with those of the same mental age who are developing typically. Studies of motivation in children with ID in the middle years of childhood or adolescence are almost non-existent. However, research conducted more than 30 years ago (Harter & Zigler, 1974) continues to be cited as evidence of motivational deficits in those with ID even though the life experiences of people with ID have changed dramatically since that time.

Barriers to bikesharing : an analysis from Melbourne and Brisbane

This study quantifies the motivators and barriers to bikeshare program usage in Australia. An online survey was administered to a sample of annual members of Australia’s two bikeshare programs based in Brisbane and Melbourne, to assess motivations for joining the schemes. Non-members of the programs were also sampled in order to identify current barriers to joining bikeshare. Spatial analysis from Brisbane revealed residential and work locations of non-members were more geographically dispersed than for bikeshare members. An analysis of bikeshare usage in Melbourne showed a strong relationship between docking stations in areas with relatively less accessible public transit opportunities. The most influential barriers to bikeshare use related to motorized travel being too convenient and docking stations not being sufficiently close to home, work and other frequented destinations. The findings suggest that bikeshare programs may attract increased membership by ensuring travel times are competitive with motorized travel, for example through efficient bicycle routing and priority progression and, by expanding docking station locations, and by increasing the level of convenience associated with scheme use. Convenience considerations may include strategic location of docking stations, ease of signing up and integration with public transport.

Experimental and numerical study of polymeric foam efficacy in portable water filled barriers

Portable, water filled road safety barriers are used to provide protection and reduce the potential hazard due to errant vehicles in areas where the road conditions change frequently (e.g. near road work sites). As part of an effort to reduce excessive working widths typical of these systems, a study was conducted to assess the effectiveness of introducing polymeric foam filled panels into the design. Surrogate impact tests of a design typical of such as barrier system were conducted utilising a pneumatically powered horizontal impact testing machine up to impact energies of 7.40 kJ. Results of these tests are utilised to examine the barrier behaviour, in addition to being used to validate a couple FE/SPH model of the barrier system. Once validated, the FE/SPH model it utilised as the basis for a parametric study into the efficacy and effects of the inclusion of polymeric foam filled panels on the performance of portable water filled road safety barriers. It was found that extruded polystyrene foam functioned well, with a greater thickness of the foam panel significantly reducing the impacting body velocity as the barrier began to translate.

Perspectives about exercise from adults with venous leg ulcers : an exploratory study

Objective Exercise has the potential to offer a range of health benefits in addition to improving healing outcomes for people with venous leg ulcers. However despite evidence based recommendations, most of these individuals do not engage in regular exercise. The aim of this study was to gain an understanding of the perspectives of adults with venous leg ulcers, in relation to exercise. Method This was a qualitative design using semi-structured interviews and discussions. Ten participants with venous leg ulceration volunteered to participate. Recruitment was through a specialist wound clinic. Verbatim data were collected by an experienced moderator using a semi-structured guide. Data saturation was reached after three group discussions and two interviews. A random selection of transcripts was sent back to the participants for verification. Thematic content analysis was used to determine major themes and categories. Two transcripts were independently analysed, categories and themes independently developed, cross checked and found comparable. Remaining transcripts were analysed using developed categories and codes. Results Regardless of their current exercise routine, participants reported exercising prior to venous leg ulceration and expressed an interest in either becoming active or maintaining an active lifestyle. Overall four themes emerged from the findings: i) participant understanding of the relationship between chronic venous insufficiency and exercise patterns, ii) fear of harm impacts upon positive beliefs and attitudes to exercise, iii) perceived factors limit exercise and iv) structured management facilitates exercise. Conclusion The value of exercise in improving outcomes in venous leg ulcers lies in its capacity to promote venous return and reduce the risk of secondary conditions in this population. Despite motivation and interest in being exercise active, people with venous leg ulcers report many obstacles. Further exploration of mechanisms that assist this patient population and promote understanding about management of barriers, coupled with promotion of enabling factors is vital for improving their exercise participation.

Continuing to drive while sleepy : the influence of sleepiness countermeasures, motivation for driving sleepy, and risk perception

Driver sleepiness is a major contributor to road crashes. The current study sought to examine the association between perceptions of effectiveness of six sleepiness countermeasures and their relationship with self-reports of continuing to drive while sleepy among 309 drivers after controlling for the influence of age, sex, motivation for driving sleepy, and risk perception of sleepy driving. The results demonstrate that the variables of age, sex, motivation, and risk perception were significantly associated with self-reports of continuing to drive while sleepy and only one countermeasure was associated with self-reports of continuing to drive while sleepy. Further, it was found that age differences in self-reports of continuing to drive while sleepy was mediated by participants’ motivation and risk perception. These findings highlight modifiable factors that could be focused on with interventions that seek to modify drivers’ attitudes and behaviours of driving while sleepy.

Performance of new-generation portable water-filled road safety barriers under vehicular impact

Portable water-filled barriers (PWFB) are roadside structures used to enhance safety at roadside work-zones. Ideally, a PWFB system is expected to protect persons and objects behind it and redirect the errant vehicle. The performance criteria of a road safety barrier system are (i) redirection of the vehicle after impact and (ii) lateral deflection within allowable limits. Since its inception, the PWFB has received criticism due to its underperformance compared to the heavier portable concrete barrier. A new generation composite high energy absorbing road safety barrier was recently developed by the authors.