Assessing Cardiovascular Risk in Regional Areas: The Healthy Hearts – Beyond City Limits Program

Background: Cardiovascular disease (CVD) is more prevalent in regional and remote Australia compared to metropolitan areas. The aim of Healthy Hearts was to determine age and sex specific CVD risk factor levels and the potential value of national risk clinics. Methods: Healthy Hearts was an observational research study conducted in four purposefully selected higher risk communities in regional Victoria, Australia. The main outcome measures were the proportion of participants with CVD risk factors with group comparisons to determine the adjusted likelihood of elevated risk factor levels. Trained personnel used a standardized protocol over four weeks per community to measure CVD risk factor levels, estimate absolute CVD risk and provide feedback and advice. Results: A total of 2125 self-selected participants were assessed (mean age 58 ± 15 years, 57% women). Overall, CVD risk factors were highly prevalent. More men than women had ≥ 2 modifiable CVD risk factors (76% vs. 68%, p < .001), pre-existing CVD (20 vs. 15%, p < .01) and a major ECG abnormality requiring follow-up (15% vs. 7%, p < .001) . Less men reported depressive symptoms compared to women (28% vs. 22%, p < .01). A higher proportion of women were obese (adjusted OR 1.36, 95% CI 1.13 to 1.63), and physically inactive (adjusted OR 1.32, 95% CI 1.07 to 1.63). Conclusions: High CVD risk factor levels were confirmed for regional Victoria. Close engagement with individuals and communities provides scope for the application of regional risk management clinics to reduce the burden of CVD risk in regional Australia.

Diversification for sustainable development in rural and regional Australia : how local community leaders conceptualise the impacts and opportunities from agriculture, tourism and mining

Although the multiple economic, environmental and social challenges threatening the viability of rural and regional communities in Australia are well-known, little research has explored how community leaders conceptualise the impact and opportunities associated with economic diversification from agriculture into alternative industries, such as tourism and mining. This qualitative research, utilising the Darling Downs in Queensland as a case study, documents how 28 local community leaders have experienced this economic diversification process. The findings reveal that local community leaders have a deep understanding about the opportunities and challenges presented by diversification, articulating a clear vision about how to achieve the best possible future for their region. Despite excitement about growth, there were concerns about preserving heritage, the increased pressure on local infrastructure and an ageing population. By documenting local leader’s insights, these findings may help inform planning for rural and regional communities and facilitate management of the exciting yet challenging process of growth and diversification

A Survey-based Study of Knowledge of Alzheimer's Disease among Health Care Staff

Background Continued aging of the population is expected to be accompanied by substantial increases in the number of people with dementia and in the number of health care staff required to care for them. Adequate knowledge about dementia among health care staff is important to the quality of care delivered to this vulnerable population. The purpose of this study was to assess knowledge about dementia across a range of health care staff in a regional health service district. Methods Knowledge levels were investigated via the validated 30-item Alzheimer's Disease Knowledge Scale (ADKS). All health service district staff with e-mail access were invited to participate in an online survey. Knowledge levels were compared across demographic categories, professional groups, and by whether the respondent had any professional or personal experience caring for someone with dementia. The effect of dementia-specific training or education on knowledge level was also evaluated. Results A diverse staff group (N = 360), in terms of age, professional group (nursing, medicine, allied health, support staff) and work setting from a regional health service in Queensland, Australia responded. Overall knowledge about Alzheimer's disease was of a generally moderate level with significant differences being observed by professional group and whether the respondent had any professional or personal experience caring for someone with dementia. Knowledge was lower for some of the specific content domains of the ADKS, especially those that were more medically-oriented, such as 'risk factors' and 'course of the disease.' Knowledge was higher for those who had experienced dementia-specific training, such as attendance at a series of relevant workshops. Conclusions Specific deficits in dementia knowledge were identified among Australian health care staff, and the results suggest dementia-specific training might improve knowledge. As one piece of an overall plan to improve health care delivery to people with dementia, this research supports the role of introducing systematic dementia-specific education or training.

Benchmarking knowledge-based urban development performance : Results from the international comparison of Helsinki

In the era of a global knowledge economy, urban regions that seek to increase their competitive edge, become destinations for talent and investment and provide prosperity and high quality of life to their inhabitants have little chance of achieving these goals without forming effective knowledge-based urban development strategies. The research reported in this paper aims to address the questions of how a knowledge-based urban development performance measurement can be undertaken and the value contribution of such measurement. The paper focuses on the city of Helsinki. This empirical study analytically investigates Helsinki’s performance from the lens of knowledge-based urban development by comparing this urban region with eight international competitors, Boston, San Francisco, Birmingham, Manchester, Melbourne, Sydney, Toronto, and Vancouver. The results of the study not only reveal a clearer understanding of Helsinki’s benchmarked performance and competitive edge considering the regional policy context along with strategic directions in strengthening its international standing and competitiveness but also provide useful insights for other urban regions that aspire to such development.

The role of knowledge intermediaries in developing firm learning capabilities

Regional innovation systems (RISs) literature has emphasized the critical role of interactive learning and knowledge exchange amongst firms and a variety of spatially connected innovation institutions as the foundation of regional innovation. Knowledge intermediaries have been analysed in terms of the technology-transaction services they provide firms and/or knowledge producers such as universities and therefore the role they play in facilitating interaction within the RIS. However, innovation also depends on the capability of the firm to learn. Some studies have suggested that intermediaries also play a role in that regard as participation in intermediary knowledge transfer programmes can contribute to the development of firm capabilities for problem-solving and learning. Our research is based on two case study intermediary programmes involving interviews with facilitators and participants. Our data show that knowledge intermediaries affect organizational learning capabilities by impacting on firms' network relationships, internal and external communication channels and internal learning processes which in turn affect the ability to interpret and use knowledge within the firm. This suggests that the role of knowledge intermediaries might be greater than facilitating interactions in the innovation system, as knowledge intermediation may affect the ability of firms to learn and absorb knowledge from their environment.

Learning about being effective mentors : professional learning communities and mentoring

This study aimed to explore experienced mentors’ understandings about professional learning communities (PLCs), mentoring and leadership. This research analyses audio-taped transcripts and written responses from 27 experienced mentors who operate in varied roles (e.g., university academics, school executives, teachers, learning support personnel). Findings indicated that PLCs can provide professional renewal for existing teachers and that mentoring within PLCs can further advance knowledge about effective practices. PLCs can include other staff members and key stakeholders (e.g., preservice teachers, teacher aides) who can contribute to the learning within the group. Mentoring and PLCs can be cost-effective strategic levers for advancing professional knowledge.

Developing capabilities for social inclusion : engaging diversity through inclusive school communities

The effort to make schools more inclusive, together with the pressure to retain students until the end of secondary school, has greatly increased both the number and educational requirements of students enrolling in their local school. Of critical concern, despite years of research and improvements in policy, pedagogy and educational knowledge, is the enduring categorisation and marginalization of students with diverse abilities. Research has shown that it can be difficult for schools to negotiate away from the pressure to categorise or diagnose such students, particularly those with challenging behaviour. In this paper, we highlight instances where some schools have responded to increasing diversity by developing new cultural practices to engage both staff and students; in some cases, decreasing suspension while improving retention, behaviour and performance.

Hepatitis B knowledge, testing, and vaccination among Chinese and Vietnamese adults in Australia

Hepatitis B is a significant public health challenge within some subpopulations in Australia, including Chinese and Vietnamese migrants. There has been limited research on hepatitis B knowledge and actions in these communities. The authors conducted a self-administered survey among 442 Chinese and 433 Vietnamese in Brisbane. Generally, the knowledge is best described as “moderate.” One in 2 could not identify the sexual transmission risk and less than one third knew that sharing foods or drinks did not spread the disease. The majority of Vietnamese (80%) and 60% of Chinese respondents indicated prior testing. Vaccination was reported in 60% of the Vietnamese and in 52% of the Chinese. Knowledge was better among Chinese people who had been tested and vaccinated compared with those who were nontested and nonvaccinated. Only 3.5% of the Chinese, but 11.6% of the Vietnamese, indicated having a positive test result hepatitis B virus. This study helps identify strategies for programs targeting both communities and practitioners.

Sociocultural animation

The emergence of global computer networks and the ubiquitous availability of advanced information and communication technology (ICT) since the mid Nineties has given rise to the hope that the traditional disadvantages faced by regional economies and regional communities could be elevated easily and swiftly. Yet, the experience of both community informatics and community development researchers and practitioners tells a different tale. Although the potential of ICT is in fact realised in some situations and locations and does provide means to ensure sustainability in some regional communities, elsewhere it has not been taken up or has not been able to elicit change for the promised better. Too many communities are still faced by a centralised structure in the context of commerce, service provision or governance and by various degrees of digital divides between connected and disconnected, between media literate and illiterate, between young and old, and between urban and rural. Many attempts to close or bridge the digital divide have been reported with various degrees of success (cf. Menou, 2001; Servon, 2002). Most of these accounts echo a common voice in that they report similar principles of action, and they reflect – in most cases unconsciously – practices of sociocultural animation. This article seeks to shed light onto the concept of sociocultural animation which is already commonplace in various forms in the arts, in education and professional development, youth work, sports, town planning, careers services, entrepreneurship and tourism. It starts by exploring the origins of sociocultural animation and draws parallels to the current state of research and practice. It unpacks the foundation of sociocultural animation and briefly describes underlying principles and how they can be applied in the context of community informatics and developing regional communities with ICT. Finally, further areas of investigation are being proposed.

Large-scale community projects in regional Queensland : unlocking creative potential and community identity : Artspoken Queensland Regional Arts and Culture Conference 2011

In this presentation, renowned arts practitioner, Sean Mee, and Nigel Lavender, Executive Director of the Queensland Music Festival, talk about how community arts practice can be used to build cultural captial in communities, using examples such large-scale musicals such as The Road We're ON (Charleville) and Behind the Cand (Bowen), Mee and Lavender highlight the importance of community-driven narrative and particiaption.

Beyond knowledge : an insight into the practice of a learning support teacher

Increasingly, schools are being asked to meet the challenges of providing inclusive classrooms for all children. Inclusion is no longer about special education for a special group of students. It is about school improvement in order to bring about the changes that are needed to classroom practices to ensure the improvement of student learning outcomes. Inclusion is no longer a policy initiative. Rather it has been transformed to become a process that moves a school towards inclusive practices that will result in school improvement, heightened student learning outcomes and greater opportunities for all students to gain equal access to education. This study focuses on the challenge of diversity as it translates into implementing inclusive practices across two secondary school contexts. I have undertaken this research in my role as a Learning Support Teacher over a period of five years. Central to my research is a constructivist ontology and a practice epistemology that aligns with a practitioner research methodology of action research. Seven generalisable propositions have emerged from this research that inform the strategies I am using to more easily accommodate legislated inclusivitiy. These propositions include: 1. School communities need to share a common understanding of equity. 2. The school principal must provide overt leadership in moving towards an inclusive school culture. 3. A whole-school approach is needed to narrow the gap between inclusion rhetoric and classroom practice. 4. Pedagogical reform is the most effective strategy for catering for diverse student learning needs. 5. Differentiating curriculum is achieved when collaborative planning teams develop appropriate units of work. 6. School communities need to make a commitment to gather, share and manage relevant information concerning students. 7. The Learning Support Teacher needs to be repositioned within a curriculum planning team.

Discussion paper and working paper series : Motivations, expectations and experiences of Australian rural and regional planners

Despite playing an extremely important role in shaping communities, the role and contribution of planners is not widely understood or acknowledged. At the same time, there is a shortage of planners in Australia, especially in non-urban areas. Thus, though an online survey of 185 rural and regional planners, this research explores their motivations, expectations and experiences. Most enjoyed and felt confident in their role, explaining that they valued the relaxed family orientated rural lifestyle and the varied nature of the planning work. Although they sometimes felt isolated, the non-urban location provided quicker progression to senior roles, the ability to engage directly with the community and to see the consequences of their decisions. Only half felt their education had prepared them well for their role, citing gaps in terms of computerised modelling, team leadership and conflict resolution skills. Their feedback centred on providing a more practical course, focussing more on regional planning, and encouraging urban and rural experience placements. As the first study to quantifiably explore rural and regional Australian planners perceptions of their role and challenges, the findings illustrate current experiences, key planning challenges, perceived educational gaps and future priorities.

Building contemporary urban spaces of knowledge and innovation : Lessons from Australian practice

In the era of global knowledge economy, urban regions that are seeking to increase their competitive edge, become destinations for talent and investment, and provide prosperity and quality of life to their inhabitants have little chance achieving their development goals without forming effective knowledge-based urban development strategies. This paper aims to shed light on the planning and development of the knowledge-based urban development phenomenon with respect to the construction of knowledge community precincts aimed at building contemporary urban spaces of knowledge and innovation. Following to a thorough review of the literature on knowledge-based urban development, the paper undertakes policy and best practice analyses to learn from the internationally renowned Australian knowledge community precincts, from Sydney, Melbourne and Brisbane, to better understand the dynamics of knowledge community precinct development practices. The paper provides a discussion on the study findings and recommendations for successfully establishing contemporary urban spaces of knowledge and innovation.

Building knowledge capabilities : an organisational learning approach

The communal nature of knowledge production predicts the importance of creating learning organisations where knowledge arises out of processes that are personal, social, situated and active. It follows that workplaces must provide both formal and informal learning opportunities for interaction with ideas and among individuals. This grounded theory for developing contemporary learning organisations harvests insights from the knowledge management, systems sciences, and educational learning literatures. The resultant hybrid theoretical framework informs practical application, as reported in a case study that harnesses the accelerated information exchange possibilities enabled through web 2.0 social networking and peer production technologies. Through complementary organisational processes, 'meaning making' is negotiated in formal face-to-face meetings supplemented by informal 'boundary spanning' dialogue. The organisational capacity building potential of this participatory and inclusive approach is illustrated through the example of the Dr. Martin Luther King, Jr. Library in San Jose, California, USA. As an outcome of the strategic planning process at this joint city-university library, communication, decision-making, and planning structures, processes, and systems were re-invented. An enterprise- level redesign is presented, which fosters contextualising information interactions for knowledge sharing and community building. Knowledge management within this context envisions organisations as communities where knowledge, identity, and learning are situated. This framework acknowledges the social context of learning - i.e., that knowledge is acquired and understood through action, interaction, and sharing with others. It follows that social networks provide peer-to-peer enculturation through intentional exchange of tacit information made explicit. This, in turn, enables a dynamic process experienced as a continuous spiral that perpetually elevates collective understanding and enables knowledge creation.

Study protocol : establishing good relationships between patients and health care providers while providing cardiac care. Exploring how patient-clinician engagement contributes to health disparities between indigenous and non-indigenous Australians in South Australia

Abstract Background: Studies that compare Indigenous Australian and non-Indigenous patients who experience a cardiac event or chest pain are inconclusive about the reasons for the differences in-hospital and survival rates. The advances in diagnostic accuracy, medication and specialised workforce has contributed to a lower case fatality and lengthen survival rates however this is not evident in the Indigenous Australian population. A possible driver contributing to this disparity may be the impact of patient-clinician interface during key interactions during the health care process. Methods/Design: This study will apply an Indigenous framework to describe the interaction between Indigenous patients and clinicians during the continuum of cardiac health care, i.e. from acute admission, secondary and rehabilitative care. Adopting an Indigenous framework is more aligned with Indigenous realities, knowledge, intellects, histories and experiences. A triple layered designed focus group will be employed to discuss patient-clinician engagement. Focus groups will be arranged by geographic clusters i.e. metropolitan and a regional centre. Patient informants will be identified by Indigenous status (i.e. Indigenous and non-Indigenous) and the focus groups will be convened separately. The health care provider focus groups will be convened on an organisational basis i.e. state health providers and Aboriginal Community Controlled Health Services. Yarning will be used as a research method to facilitate discussion. Yarning is in congruence with the oral traditions that are still a reality in day-to-day Indigenous lives. Discussion: This study is nestled in a larger research program that explores the drivers to the disparity of care and health outcomes for Indigenous and non-Indigenous Australians who experience an acute cardiac admission. A focus on health status, risk factors and clinical interventions may camouflage critical issues within a patient-clinician exchange. This approach may provide a way forward to reduce the appalling health disadvantage experienced within the Indigenous Australian communities. Keywords: Patient-clinician engagement, Qualitative, Cardiovascular disease, Focus groups, Indigenous