Sustainability of a successful health and nutrition program in a remote Aboriginal community

OBJECTIVE: To assess the long term effect of a nutrition program in a remote Aboriginal community (Minjilang). DESIGN: Evaluation of nutritional outcomes over the three years before and the three years after a health and nutrition program that ran from June 1989 to June 1990. Turnover of food items at the community store was used as a measure of dietary intake at Minjilang and a comparison community. SETTING: A community of about 150 Aboriginal people live at Minjilang on Croker Island, 240 km north-east of Darwin. A similar community of about 300 people on another island was used as the comparison. RESULTS: The program produced lasting improvements in dietary intake of most target foods (including fruit, vegetables and wholegrain bread) and nutrients (including folate, ascorbic acid and thiamine). Sugar intake fell in both communities before the program, but the additional decrease in sugar consumption during the program at Minjilang "rebounded" in the next year. Dietary improvements in the comparison community were delayed and smaller than at Minjilang. CONCLUSIONS: The success of the program at Minjilang was linked to an ongoing process of social change, which in turn provided a stimulus for dietary improvement in the comparison community. When Aboriginal people themselves control and maintain ownership of community-based intervention programs, nutritional improvements can be initiated and sustained.

Providing 'best practice' placements begins with mentoring skills : overview of the Program of Experience in the Palliative Approach (PEPA) quality improvement initiatives for mentors

Objectives PEPA is funded by the Department of Health and Ageing and aims to further improve the skill and confidence of the generalist workforce to work with people with palliative care needs. Recent quality improvement initiatives to promote transfer of learning into practice include appointment of a clinical educator, implementation of an online module for mentors and delivery of a mentoring workshop (collaborating with NSAP and PCC4U). This paper presents an overview of outcomes from these quality improvement initiatives. Methods PEPA host sites are selected based on their specialist palliative care level. Host site managers are surveyed six-monthly and participants are surveyed pre and three months post-placement to collect open and fixed response data on their experience of the program. Participants in the mentoring workshop (n=39) were asked to respond to a survey regarding the workshop outcomes. Results The percentage of placement participants who strongly agreed they ‘have the ability to implement the interventions required for people who have a life-limiting illness’ increased from 35% in 2011 (n=34) to 51% in 2012 (n=91) post-placement. Responses from mentor workshop participants indicated that 76% of respondents (n=25) agreed that they were able to identify principles for mentoring in the context of palliative care. In 2012, 61% of host site managers (n=54) strongly agreed that PEPA supports clinician working with people with a life-limiting illness. Conclusion Strategies to build the capabilities of palliative care professionals to mentor and support the learning experience of PEPA participants are critical to ongoing improvements of the program.

An examination of the liability of a construction contract certifier who gets it wrong

Construction contracts often provide that decisions under the contract will be made by a certifier. This paper reviews the liability issues when a certifier makes a mistake. We do that in light of recent pronouncements by the High Court of Australia and the New South Wales Court of Appeal on negligence. We look at this question in the context of traditional construction contract arrangements and also consider the implications for Public Private Partnerships and the typical contract arrangements entered into to facilitate these transactions.

The view from here : educational program creates momentum for positive change

Kate Nayton, Elaine Fielding and Elizabeth Beattie describe how they developed a successful program to educate hospital staff about dementia care. The program may soon be trialled in other acute care facilities.

Waves for change : the role of the South Tarawa-based women's interests program in the decolonisation process of the Gilbert Islands

This thesis has created a space for women in the history of the decolonisation of the Gilbert Islands. It traces the historical development of the national women's interests program in the Republic of Kiribati (formerly of the Gilbert and Ellice Islands Colony (GEIC)) as it was implemented through a network of women's clubs during the 1960s and 1970s. This thesis has provided the first history and interpretation of the Indigenous women's interests movement as it impacted the Gilbert Islands. It offers a narrative of the movement in terms of three overlapping waves of women leaders, based on an analysis of fieldwork, archival research and interviews conducted on South Tarawa, Kiribati.

Learning routines used by firms during construction of infrastructure projects using the alliance procurement method

Collaborative contracting has emerged over the past 15 years as an innovative project delivery framework that is particularly suited to infrastructure projects. Australia leads the world in the development of project and program alliance approaches to collaborative delivery. These approaches are considered to promise superior project results. However, very little is known about the learning routines that are most widely used in support of collaborative projects in general and alliance projects in particular. The literature on absorptive capacity and dynamic capabilities indicates that such learning enhances project performance. The learning routines employed at corporate level during the operation of collaborative infrastructure projects in Australia were examined through a large survey conducted in 2013. This paper presents a descriptive summary of the preliminary findings. The survey captured the experiences of 320 practitioners of collaborative construction projects, including public and private sector clients, contractors, consultants and suppliers (three per cent of projects were located in New Zealand, but for brevity’s sake the sample is referred to as Australian). The majority of projects identified used alliances (78.6%); whilst 9% used Early Contractor Involvement (ECI) contracts and 2.7% used Early Tender Involvement contracts, which are ‘slimmer’ types of collaborative contract. The remaining 9.7% of respondents used traditional contracts that employed some collaborative elements. The majority of projects were delivered for public sector clients (86.3%), and/or clients experienced with asset procurement (89.6%). All of the projects delivered infrastructure assets; one third in the road sector, one third in the water sector, one fifth in the rail sector, and the rest spread across energy, building and mining. Learning routines were explored within three interconnected phases: knowledge exploration, transformation and exploitation. The results show that explorative and exploitative learning routines were applied to a similar extent. Transformative routines were applied to a relatively low extent. It was also found that the most highly applied routine is ‘regularly applying new knowledge to collaborative projects’; and the least popular routine was ‘staff incentives to encourage information sharing about collaborative projects’. Future research planned by the authors will examine the impact of these routines on project performance.

The CLIMATE schools combined study : a cluster randomised controlled trial of a universal Internet-based prevention program for youth substance misuse, depression and anxiety

Background Anxiety, depressive and substance use disorders account for three quarters of the disability attributed to mental disorders and frequently co-occur. While programs for the prevention and reduction of symptoms associated with (i) substance use and (ii) mental health disorders exist, research is yet to determine if a combined approach is more effective. This paper describes the study protocol of a cluster randomised controlled trial to evaluate the effectiveness of the CLIMATE Schools Combined intervention, a universal approach to preventing substance use and mental health problems among adolescents. Methods/design Participants will consist of approximately 8400 students aged 13 to 14-years-old from 84 secondary schools in New South Wales, Western Australia and Queensland, Australia. The schools will be cluster randomised to one of four groups; (i) CLIMATE Schools Combined intervention; (ii) CLIMATE Schools - Substance Use; (iii) CLIMATE Schools - Mental Health, or (iv) Control (Health and Physical Education as usual). The primary outcomes of the trial will be the uptake and harmful use of alcohol and other drugs, mental health symptomatology and anxiety, depression and substance use knowledge. Secondary outcomes include substance use related harms, self-efficacy to resist peer pressure, general disability, and truancy. The link between personality and substance use will also be examined. Discussion Compared to students who receive the universal CLIMATE Schools - Substance Use, or CLIMATE Schools - Mental Health or the Control condition (who received usual Health and Physical Education), we expect students who receive the CLIMATE Schools Combined intervention to show greater delays to the initiation of substance use, reductions in substance use and mental health symptoms, and increased substance use and mental health knowledge

Improving dental and medical students’ psychological health using a self-development coaching program : a pilot study

Introduction: Dental and medical students worldwide, including in Saudi Arabia, have been reported to have a high incidence of poor psychological health, such as depression, stress, anxiety, and lowlife satisfaction. Self-development coaching programs have become an increasingly popular way to improve individuals’ lives. However, few studies have evaluated the psychological effects of such programs among dental and medical students. Moreover, no studies have been conducted on self-development coaching programs in Saudi Arabia. Aims: The aim of this study was to assess the feasibility of a larger study via a pilot study and to acquire preliminary findings about the effectiveness of a self-development coaching program on psychological health among dental and medical students in Saudi Arabia. Methods: A pre-post interventional study design was used to test a self-development coaching program (How to be an Ultra-Super Student) with a sample of medical students (n=17) at Umm Al-Qura University at Saudi Arabia. The outcome measures were students’ psychological distress (depression, anxiety, and stress), life satisfaction, self-efficacy, the coach, and coaching program characteristics. Results: The study showed that there was a significant improvement in depression (p=0.04), self-efficacy (p=0.02), and satisfaction with life (p=0.04), which supported the feasibility of a large study in the future. Conclusions: The study’s findings encourage the implementation of a randomized, controlled trial study with a larger sample to further test the effectiveness of using self-development coaching programs with medical and dental students in Saudi Arabia to improve their psychological health.

Satisfaction survey for a medication management program : satisfaction guaranteed?

BACKGROUND Providing clinical pharmacy services to patients in their homes after discharge from hospital has been reported to reduce health care costs and improve outcomes. The Medication Management Program of the Fraser Health Authority involves pharmacists making home visits to provide clinical pharmacy services to elderly patients who have recently been discharged from hospital and others considered to be at high risk for adverse drug events. Although clinical and economic outcomes of this program have been evaluated, humanistic outcomes such as satisfaction have not been assessed. Moreover, very little evaluation of patient satisfaction with home pharmacy services has been reported in the literature. OBJECTIVE To evaluate patient satisfaction with the Medication Management Program. METHODS A telephone survey instrument, consisting of 7 Likert-scale items and 2 open-ended questions, was developed and administered to patients who received a home pharmacist visit between September 1 and November 23, 2011. In addition to the survey responses, demographic and clinical data for both respondents and nonrespondents were collected. RESULTS Of the 175 patients invited to participate in the survey, 103 (58.9%) agreed to participate. The majority of respondents agreed or strongly agreed with all of the survey items, indicating satisfaction with the program. For example, 97 (94%) agreed or strongly agreed that they would recommend the pharmacist home visit program continue to be available, and all 103 (100%) agreed or strongly agreed that they were satisfied with the pharmacist home visit. Respondents provided some suggestions for program improvement. CONCLUSIONS The survey findings demonstrate that patients were satisfied with the home clinical pharmacy services offered through the Fraser Health Medication Management Program.

Internet teaching foundation for the Remote Sensing Core Curriculum program

The Remote Sensing Core Curriculum (RSCC) was initiated in 1993 to meet the demands for a college-level set of resources to enhance the quality of education across national and international campuses. The American Society of Photogrammetry and Remote Sensing adopted the RSCC in 1996 to sustain support of this educational initiative for its membership and collegiate community. A series of volumes, containing lectures, exercises, and data, is being created by expert contributors to address the different technical fields of remote sensing. The RSCC program is designed to operate on the Internet taking full advantage of the World Wide Web (WWW) technology for distance learning. The issues of curriculum development related to the educational setting, with demands on faculty, students, and facilities, is considered to understand the new paradigms for WWW-influenced computer-aided learning. The WWW is shown to be especially appropriate for facilitating remote sensing education with requirements for addressing image data sets and multimedia learning tools. The RSCC is located at http://www.umbc.edu/rscc. The Remote Sensing Core Curriculum (RSCC) was initiated in 1993 to meet the demands for a college-level set of resources to enhance the quality of education across national and international campuses. The American Society of Photogrammetry and Remote Sensing adopted the RSCC in 1996 to sustain support of this educational initiative for its membership and collegiate community. A series of volumes, containing lectures, exercises, and data, is being created by expert contributors to address the different technical fields of remote sensing. The RSCC program is designed to operate on the Internet taking full advantage of the World Wide Web (WWW) technology for distance learning. The issues of curriculum development related to the educational setting, with demands on faculty, students, and facilities, is considered to understand the new paradigms for WWW-influenced computer-aided learning. The WWW is shown to be especially appropriate for facilitating remote sensing education with requirements for addressing image data sets and multimedia learning tools. The RSCC is located at http://www.umbc.edu/rscc.

Evaluating NEXUS: A suicide prevention program for young people from refugee backgrounds (2007 – 2009)

Although suicide deaths in Australia continue to decline since the peak of 2,720 suicide deaths in 1997, youth suicide and self-harm are a major health issue. In 2006, in the 20 to 24 year age group, suicide accounted for approximately 21% of all male deaths and 14% of all female deaths. There is a lack of solid data on the rates of suicide and self-harm among young people from refugee backgrounds. However, this population faces a significant number of post-resettlement stressors that may add to their vulnerability and increase their risk of suicide and self-harm. The NEXUS program is an innovative strategy developed by the Queensland Program of Assistance to Survivors of Torture and Trauma (QPASTT) that aims to reduce risk factors for suicide and self-harm and to promote protective factors among youth from refugee backgrounds living in Brisbane and Toowoomba. QPASTT is a non-government organisation that provides culturally appropriate support services to refugee and humanitarian entrants to Australia. QPASTT’s primary function is to provide counselling, advocacy support and community development activities for survivors of torture and trauma at an individual, family and community level. Since 2002 the NEXUS program has been developed and implemented by QPASTT. Since then, this multi-component program has been funded by the Commonwealth Department of Health and Ageing through the National Suicide Prevention Strategy (NSPS). NSPS funding of local community suicide prevention activities will contribute to the outcomes specified in the strategic framework: Living is for Everyone (LIFE): A framework for prevention of suicide and self-harm in Australia. The focus of this report is the evaluation of the NEXUS program conducted by QPASTT between August 2007 and May 2009.

Lessons from a face-to-face meeting on embedding Aboriginal and Torres Strait Islander perspectives : ‘A contract of intimacy’

This paper presents the findings from a conversation between an Aboriginal educator and a non-Indigenous pre-service educator about the importance and complexities of building productive partnerships. Although the participants focused on the challenges and benefits of building relationships between Aboriginal and Torres Strait Islander educators and non-Indigenous educators in Australian early years settings, the more significant outcome of the meeting was the personal connection two young women were able to make when a friendship began to develop. The project was intended to enable an opportunity for the participants ‘to engage in reflexivity on their pedagogic work’, something Mills (2012) understands as crucial to the support of social justice and transformation in the classroom.

Mindfulness-meditation on the move : implementation of an ACT-based mindfulness practice intervention and training within a University Dance program

As part of the introduction of a broader dance medicine and science related health and wellbeing program, a 9 week mindfulness-meditation ACT-based program was delivered to all students undertaking full-time University dance training (N = 106). The aim of the program was to assist students in the further development of performance psychology skills that could be applied in both performance and non-performance settings. Participant groups were comprised of both male (N = 12) and female (N = 94) students from across all three year levels of two undergraduate dance courses, divided into three groups by mixed year levels due to timetable scheduling requirements. Pre- and post-testing was undertaken utilising the Mindful Attention Awareness Scale (MAAS-15), a uni-dimensional measure of mindfulness, in addition to qualitative questions checking the current level of awareness and understanding of mindfulness practice and its application. Weekly sessions were conducted by qualified sport and exercise psychologists and covered key practices such as: Mindfulness of Body, Mindfulness of Breathing, Mindfulness of Sounds, ACT-based and general Imagery exercises, Developing Open Awareness, Mindfulness of Emotions, and Developing Inner Stillness. Students were required to maintain a reflective journal that was utilised at the end of each weekly session, in addition to completion of a mid-Semester reflective debrief. Teaching staff additionally attended the weekly sessions and linked the mindfulness practice learnings into the student’s practical dance and academic classes where appropriate. Anecdotal feedback indicates that participation in the mindfulness-meditation sessions and the development of these mental skills has resulted in positive performance and personal outcomes. Observations collated from staff and students, results from the data collection phases and recommendations regarding future applications within dance training settings will be discussed within the presentation.