Influencers on quality of life as reported by people living with dementia in long-term care: A descriptive exploratory approach

Background Over half of the residents in long-term care have a diagnosis of dementia. Maintaining quality of life is important, as there is no cure for dementia. Quality of life may be used as a benchmark for caregiving, and can help to enhance respect for the person with dementia and to improve care provision. The purpose of this study was to describe quality of life as reported by people living with dementia in long-term care in terms of the influencers of, as well as the strategies needed, to improve quality of life. Methods A descriptive exploratory approach. A subsample of twelve residents across two Australian states from a national quantitative study on quality of life was interviewed. Data were analysed thematically from a realist perspective. The approach to the thematic analysis was inductive and data-driven. Results Three themes emerged in relation to influencers and strategies related to quality of life: (a) maintaining independence; (b) having something to do, and; (c) the importance of social interaction. Conclusions The findings highlight the importance of understanding individual resident needs and consideration of the complexity of living in large group living situations, in particular in regard to resident decision-making.

The effectiveness of meaningful occupation interventions for people living with dementia in residential aged care: A systematic review protocol

Review questions/objective What is the effectiveness of meaningful occupation interventions for people living with dementia in residential aged care facilities? More specifically, the objectives are to identify: The effectiveness of interventions based on engaging residents of residential aged care facilities who have dementia in meaningful occupation (activities that have meaning for the individual) on: quality of life, behavioral and psychological symptoms of dementia (such as agitation, aggression, depression, wandering, apathy, etc.), mood, function, cognition, and sleep. Inclusion criteria Types of participants This review will consider studies that include participants with a confirmed diagnosis of any type of dementia living in residential aged care facilities / long term care/nursing homes/permanent care. Types of intervention(s)/phenomena of interest This review will consider studies that evaluate non-pharmacological interventions that are based on occupational or activity interventions considered to be meaningful to the person with dementia, and tailoring the intervention to meet their needs, abilities, interests and/or preferences will be required as part of the study’s methodology. Such interventions may include reminiscence therapy, exercise therapy, music therapy, individualized activity, behavioral interventions, recreational therapy, diversional therapy and psychosocial interventions. Trials of combinations of two or more such interventions will also be considered. Interventions may be in comparison to usual care, other meaningful occupation interventions, or any other non-pharmacological control or comparator.

Active aging: Exploration into self-ratings of "being active," out-of-home physical activity, and participation among older Australian adults living in four different settings

We examined whether self-ratings of “being active” among older people living in four different settings (major city high and lower density suburbs, a regional city, and a rural area) were associated with out-of-home participation and outdoor physical activity. A mixed-methods approach (survey, travel diary, and GPS tracking over a one-week period) was used to gather data from 48 individuals aged over 55 years. Self-ratings of “being active” were found to be positively correlated with the number of days older people spent time away from home but unrelated to time traveled by active means (walking and biking). No significant differences in active travel were found between the four study locations, despite differences in their respective built environments.The findings suggest that additional strategies to the creation of “age-friendly” environments are needed if older people are to increase their levels of outdoor physical activity. “Active aging” promotion campaigns may need to explicitly identify the benefits of walking outdoors to ambulatory older people as a means of maintaining their overall health, functional ability, and participation within society in the long-term and also encourage the development of community-based programs in order to facilitate regular walking for this group.

The garden of Australian dreams: The moral rights of landscape architects

This article considers the moral rights controversy over plans to redesign the landscape architecture of the National Museum of Australia. This dispute raises issues about the nature and scope of moral rights; the professional standing of landscape architects; and the culture wars taking place in Australia. Part 1 considers the introduction of the Copyright Amendment (Moral Rights) Act 2000 (Cth), with its special regime for architecture and public sculpture. It focuses upon a number of controversies which have arisen in respect of copyright law and architecture - involving the National Gallery of Australia, the National Museum of Australia, the Pig ’n Whistle pub, the South Bank redevelopment, and the new Parliament House. Part 2 examines the dispute over the Garden of Australian Dreams. The controversy is a striking one - as the Australian Government sought to subvert the spirit of its own legislation, the Copyright Amendment (Moral Rights) Act 2000 (Cth). Part 3 engages in a comparative study of how copyright law and architecture are dealt with in other jurisdictions. In particular, it considers the dual operation of the Architectural Works Copyright Act 1990 (US) and the Visual Artists Rights Act 1990 (US) and a number of controversies in the United States - over the Tilted Arc sculpture, a Los Angeles tower block that appeared in the film Batman Forever, a community garden mural, a sculpture park, and the Freedom Tower.

‘A contributing life’: Living a contributing life as ‘a person’, ‘an artist’ and ‘an artist with a mental illness’

The Australian National Mental Health Commission, recently adopted a focus on ‘a contributing life’ to acknowledge the importance of full and meaningful participation in community life. This concept compels new conversations about the complex nature of every day and whole of life experiences for people with lived experience of mental illness. This article reflects on narratives by eight artists with lived experience of mental illness, in Australia to understand how opportunities are available through art for people with lived experience of mental illness to lead a contributing life. A twelve month study gained insight of how participants saw themselves, made meaning and sense of their experiences, and how each person asserted their choice to be an artist. This article shares a common premise held by the participants to choose a “way of life as ‘who I am’”. This declaration emphasised the relevance of living a contributing life as ‘a person’, ‘an artist’ and ‘an artist with a mental illness’. A number of conceptual issues are raised in light of the findings, not least how opportunities for participation are framed and available, or otherwise, to live a contributing life.

Adoption of alternative habitats by a threatened, "obligate" forest-dwelling bat in a fragmented landscape

While they are among the most ecologically important animals within forest ecosystems, little is known about how bats respond to habitat loss and fragmentation. The threatened lesser short-tailed bat (Mystacina tuberculata), considered to be an obligate deep-forest species, is one of only 2 extant land mammals endemic to New Zealand; it plays a number of important roles within native forests, including pollination and seed dispersal, and rarely occurs in modified forests. We used radiotelemetry to study the movements, roosting behavior, and habitat use of M. tuberculata within a fragmented landscape comprised of 3 main habitat types: open space (harvested forest and pastoral land), native forests, and exotic pine plantations. We found that the bats had smaller home-range areas and travelled shorter nightly distances than populations investigated previously from contiguous native forest. Furthermore, M. tuberculata occupied all 3 habitat types, with native forest being preferred overall. However, individual variation in habitat selection was high, with some bats preferring exotic plantation and open space over native forest. Roosting patterns were similar to those previously observed in contiguous forest; individual bats often switched between communal and solitary roosts. Our findings indicate that M. tuberculata exhibit some degree of behavioral plasticity that allows them to adapt to different landscape mosaics and exploit alternative habitats. To our knowledge, this is the first such documentation of plasticity in habitat use for a bat species believed to be an obligate forest-dweller.

Understanding past climate variation and environmental change for the future of an iconic landscape – K'gari Fraser Island, Queensland, Australia

The unique combination of landscapes and processes that are present and operate on Fraser Island (K'gari) create a dynamic setting that is capable of recording past environmental events, climate variations and former landscapes. Likewise, its geographic position makes Fraser Island sensitive to those events and processes. Based on optically stimulated luminescence dating, the records archived within the world's largest sand island span a period that has the potential to exceed 750 ka and contain specific records that are of extremely high resolution over the past 40,000 years. This is due to the geographic position of Fraser Island, which lies in the coastal subtropical region of Queensland Australia. Fraser Island is exposed to the open ocean currents of the Coral Sea on the east coast and the waters of Hervey Bay on its western margin and is positioned to receive moisture from the Indo-Australian monsoon, southeast trade winds and experiences occasional tropical and ex-tropical cyclones. We review literature that presents the current level of understanding of sea level change, ecological variation and environmental change on Fraser Island. The previous works illustrate the importance of Fraser Island and may link processes, environments and climates on Fraser Island with global records.

Connecting soundscape to landscape: Which acoustic index best describes landscape configuration?

Soundscape assessment has been proposed as a remote ecological monitoring tool for measuring biodiversity, but few studies have examined how soundscape patterns vary with landscape configuration and condition. The goal of our study was to examine a suite of published acoustic indices to determine whether they provide comparable results relative to varying levels of landscape fragmentation and ecological condition in nineteen forest sites in eastern Australia. Our comparison of six acoustic indices according to time of day revealed that two indices, the acoustic complexity and the bioacoustic index, presented a similar pattern that was linked to avian song intensity, but was not related to landscape and biodiversity attributes. The diversity indices, acoustic entropy and acoustic diversity, and the normalized difference soundscape index revealed high nighttime sound, as well as a dawn and dusk chorus. These indices appear to be sensitive to nocturnal biodiversity which is abundant at night in warm, subtropical environments. We argue that there is need to better understand temporal partitioning of the soundscape by specific taxonomic groups, and this should involve integrated research on amphibians, insects and birds during a 24 h cycle. The three indices that best connected the soundscape with landscape characteristics, ecological condition and bird species richness were acoustic entropy, acoustic evenness and the normalized difference soundscape index. This study has demonstrated that remote soundscape assessment can be implemented as an ecological monitoring tool in fragmented Australian forest landscapes. However, further investigation should be dedicated to refining and/or combining existing acoustic indices and also to determine if these indices are appropriate in other landscapes and for other survey purposes.

A qualitative exploration of parental experiences of stigma while living with HIV in Bangladesh

With much of the focus on the “risk” groups, families have often been less studied in HIV research. Further, because of a focus on the aetiology and epidemiology of HIV, the social impacts associated with HIV on families and neighbours are sometimes overlooked. This study examined parental experiences of stigma and discrimination while living with HIV within a family context in Bangladesh. A qualitative research design using a grounded theory approach was used for this research. Data was collected through in-depth interviews with 19 HIV-positive parents, recruited with the support of two self-help groups of HIV-positive people, in two settings namely Khulna and Dhaka in Bangladesh. The findings indicate that HIV-positive parents held the view that they continue to experience significant stigma and their narratives clearly show how this affected them and their children. A range of informal practices were enacted in everyday contexts by extended family and community members to identify, demarcate and limit the social interaction of HIV-positive parents. Parents highlighted a number of factors including negative thoughts and behaviours, rejection, isolation and derogatory remarks as manifestations of stigma and discrimination, impacting upon them and their children because of their association with HIV.

Relationship between living alone and food and nutrient intake

The increase in the number of individuals living alone has implications for nutrition and health outcomes. This review aimed to investigate whether there is a difference in food and nutrient intake between adults living alone and those living with others. Eight electronic databases were searched, using terms related to living alone, nutrition, food, and socioeconomic factors. Forty-one papers met the inclusion criteria, and data of interest were extracted. Results varied but suggested that, compared with persons who do not live alone, persons who live alone have a lower diversity of food intake, a lower consumption of some core foods groups (fruit, vegetables, and fish) and a higher likelihood of having an unhealthy dietary pattern. Associations between living alone and nutrient intake were unclear. Men living alone were more often observed to be at greater risk of undesirable intakes than women. The findings of this review suggest that living alone could negatively affect some aspects of food intake and contribute to the relationship between living alone and poor health outcomes, although associations could vary between socioeconomic groups. Further research is required to help to elucidate these findings.

Deltaic urbanism for living with flooding in Southern Vietnam

Waterfront communities in the Mekong Delta live with the inundation of their homes and businesses from seasonal flooding every year. This project investigated housing types, social practices and feelings of vulnerability of local people in the Cai Rang waterfront community in Can Tho City. The project made a significant contribution to methods for assessing vulnerability, adaptability and resilience of inhabitants of flood-prone housing in Vietnam. It also developed a new concept of 'Deltaic Urbanism' that offers a better urbanist approach specifically for deltaic regions subject to the potential impacts of climate change.

Measuring impact: Positioning evaluation in the Australian arts and culture landscape

Arts culture organisations and funding authorities increasingly need to evaluate the impact of festivals, events and performances. Economic impacts are often privileged over 'soft data' about community experience and engagement. This new book offers a timely and scholarly demonstration of how cultural value and impact can be evaluated. It offers an innovative approach whereby the relationship developed between the researchers/evaluator and the commissioning arts and cultural producer provides an opportunity to rethink the traditional process of reporting back on value and impact through the singular entity of funds acquittal. Using three commissioned evaluations undertaken at an Australian university as an extended case study, the book investigates the two positions most often adopted by researchers/evaluators - embedded and collaborative, or external and distanced - and argues the merits and deficiencies of the two approaches. Offering an examination of how arts evaluation 'works' in theory and practice and more importantly, why it is needed now and in the future to demonstrate the reach and cultural gains from arts and cultural projects, this will be essential reading for students in arts management, professionals working in arts and cultural organisations, scholars working in association with creative industries and cultural development.

Visual openness in urban environments: Measuring visual openness and visibility to natural landscapes in a changing urban landscape in Gold Coast, Australia

The visual characteristics of urban environments have been changing dramatically with the growth of cities around the world. Protection and enhancement of landscape character in urban environments have been one of the challenges for policy makers in addressing sustainable urban growth. Visual openness and enclosure in urban environments are important attributes in perception of visual space which affect the human interaction with physical space and which can be often modified by new developments. Measuring visual openness in urban areas results in more accurate, reliable, and systematic approach to manage and control visual qualities in growing cities. Recent advances in techniques in geographic information systems (GIS) and survey systems make it feasible to measure and quantify this attribute with a high degree of realism and precision. Previous studies in this field do not take full advantage of these improvements. This paper proposes a method to measure the visual openness and enclosure in a changing urban landscape in Australia, on the Gold Coast, by using the improved functionality in GIS. Using this method, visual openness is calculated and described for all publicly accessible areas in the selected study area. A final map is produced which shows the areas with highest visual openness and visibility to natural landscape resources. The output of this research can be used by planners and decision-makers in managing and controlling views in complex urban landscapes. Also, depending on the availability of GIS data, this method can be applied to any region including non-urban landscapes to help planners and policy-makers manage views and visual qualities.

The Australian litigation landscape - Oral and Maxillofacial Surgery and general dentistry (oral surgery procedures): An analysis of litigation cases

Background: There are persistent concerns about litigation in the dental and medical professions. These concerns arise in a setting where general dentists are more frequently undertaking a wider range of oral surgery procedures, potentially increasing legal risk. Methods: Judicial cases dealing with medical negligence in the fields of general dentistry (oral surgery procedure) and Oral and Maxillofacial Surgery were located using the three main legal databases. Relevant cases were analysed to determine the procedures involved, the patients’ claims of injury, findings of negligence, and damages awarded. A thematic analysis of the cases was undertaken to determine trends. Results: Fifteen cases over a twenty-year period were located across almost all Australian jurisdictions (eight cases involved general dentists; seven cases involved Oral and Maxillofacial Surgeons). Eleven of the fifteen cases involved determinations of whether or not the practitioner had failed in their duty of care; negligence was found in six cases. Eleven of the fifteen cases related to molar extractions (eight specifically to third molar). Conclusions: Dental and medical practitioners wanting to manage legal risk should have regard to circumstances arising in judicial cases. Adequate warning of risks is critical, as is offering referral in appropriate cases. Pre-operative radiographs, good medical records, and processes to ensure appropriate follow-up are also important.