An exploratory study of grief and health-related quality of life for caregivers of people with dementia

The aim of this qualitative study was to explore key positive and negative factors that impact on grief resolution and health outcomes of caregivers who were caring, or had cared, for a family member with dementia who had died. The study was a scoping study and involved face-to-face interviews with these family caregivers (N ¼ 13). Results indicated a complex interaction of issues (many unique to dementia caregiving) which in different combinations acted as protective or risk factors for caregiver outcomes. Interaction of individual characteristics, role appraisal, value of intrinsic and extrinsic resources, and experiences with health professionals during the caregiving period and around the death of their relative were shown to have the most influence on caregiver outcomes. Psychological resilience and satisfaction with caregiving were protective against negative outcomes while unresolved grief was a risk factor. These findings highlight the potential benefits of multicomponent, holistic dementia caregiver interventions.

Placement Trajectory : mapping the journeys of children and young people in out-of-home care

Significant problems confront our child protection out-of-home care system including: high costs; increasing numbers of children and young people entering and remaining in care longer; high frequency of placement movement; and, negative whole-of-life outcomes for children and young people who have exited care. National policy and research agendas recognise the importance of enhancing the evidence base in out-of-home care to inform the development of policy, programs and practice, and improve longitudinal outcomes of children and young people. The authors discuss the concept of placement trajectory as a framework for research and systems analysis in the out-of-home context. While not without limitations, the concept of placement trajectory is particularly useful in understanding the factors influencing placement movement and stability. Increasing the evidence base in this area can serve to enhance improved outcomes across the lifespan for children and young people in the out-of-home care system.

Improving public spaces for young people : the contribution of participatory research

The objectives of this chapter are to examine the contribution of public spaces to the wellbeing of young people and how participatory action research can be used as a process tool for contextually responsive, collaborative, iterative and multi-method community level practice. The addition of a spatial frame to practice can open up unexpected alliances and opportunities for enhancing the wellbeing of people.

Dietetic practice by Australian and Canadian dietitians with people with Parkinson's disease

Although Parkinson’s disease (PD) is a complex disease for which appropriate nutrition management is important, limited evidence is currently available to support dietetic practice. Existing PD-specific guidelines do not span all phases of the Nutrition Care Process (NCP). This study aimed to document PD-specific nutrition management practice by Australian and Canadian dietitians. DAA members and PEN subscribers were invited to participate in an online survey (late 2011). Eighty-four dietitians responded (79.8% Australian). The majority (70.2%) worked in the clinical setting. Existing non-PD guidelines were used by 52.4% while 53.6% relied on self-initiated literature reviews. Weight loss/malnutrition, protein intake, dysphagia and constipation were common issues in all NCP phases. Respondents also requested more information/evidence for these topics. Malnutrition screening (82.1%) and assessment (85.7%) were routinely performed. One-third did not receive referrals for weight loss for overweight/obesity. Protein intake meeting gender/age recommendations (69.0%), and high energy/high protein diets to manage malnutrition (82.1%) were most commonly used. Constipation management was through high fibre diets (86.9%). Recommendations for spacing of meals and PD medications varied with 34.5% not making recommendations. Nutritional diagnosis (70.2%) and stage of disease (61.9%) guided monitoring frequency. Common outcome measures included appropriate weight change (97.6%) and regular bowel movements (88.1%). With limited PD-specific guidance, dietitians applied best available evidence for other groups with similar issues. Dietitians requested evidence-based guidelines specifically for the nutritional management of PD. Guideline development should focus on those areas reported as commonly encountered. This process can identify the gaps in evidence to guide future research.

Use of a photographic food diary method to document dietary intake in people with Parkinson's Disease

Cognitive impairment and physical disability are common in Parkinson’s disease (PD). As a result diet can be difficult to measure. This study aimed to evaluate the use of a photographic dietary record (PhDR) in people with PD. During a 12-week nutrition intervention study, 19 individuals with PD kept 3-day PhDRs on three occasions using point-and-shoot digital cameras. Details on food items present in the PhDRs and those not photographed were collected retrospectively during an interview. Following the first use of the PhDR method, the photographer completed a questionnaire (n=18). In addition, the quality of the PhDRs was evaluated at each time point. The person with PD was the sole photographer in 56% of the cases, with the remainder by the carer or combination of person with PD and the carer. The camera was rated as easy to use by 89%, keeping a PhDR was considered acceptable by 94% and none would rather use a “pen and paper” method. Eighty-three percent felt confident to use the camera again to record intake. Of the photos captured (n=730), 89% were of adequate quality (items visible, in-focus), while only 21% could be used alone (without interview information) to assess intake. Over the study, 22% of eating/drinking occasions were not photographed. PhDRs were considered an easy and acceptable method to measure intake among individuals with PD and their carers. The majority of PhDRs were of adequate quality, however in order to quantify intake the interview was necessary to obtain sufficient detail and capture missing items.

A better future for young people leaving care

The Australian National Homelessness Research Agenda funded this study which explored post-care homelessness experiences of young people, asked them what they considered helpful, and identified practice and policy implications. Participants were 48 care leavers aged 19 to 23 years in Queensland and Victoria. Of these 17 young people were interviewed twice over a four month period. In addition focus groups were held with service providers and current postcare service arrangements in the two states mapped. The study found there is a need for policy and practice to more effectively orient towards a holistic and future oriented view of outcomes for young people transitioning from care.

Public Space and the Marginalisation of Children and Young People

Throughout much of the world, urban and rural public spaces may be said to be under attack by property developers, commercial interests and also attempts by civic authorities to regulate, restrict, reframe and rebrand these spaces. A consequence of the increasingly security driven, privatised, commercial and surveilled nature of public space is the exclusion and displacement of those considered ‘flawed’ and unwelcome in the ‘spectacular’ consumption spaces of many major urban centres. In the name of urban regeneration, processes of securitisation, ‘gentrification’ and creative cities initiatives can act to refashion public space as sites of selective inclusion and exclusion. The use of surveillance and other control technologies as deployed in and around the UK ‘Riots’ of 2011 may help to promote and encourage a passing sense of personal safety and confidence in using public space. Through systems of social sorting, the same surveillance assemblages can also further the physical, emotional and psychological exclusion of certain groups and individuals, deemed to be both ‘out of time and out of place’ in major zones of urban, conspicuous, consumption. In this harsh environment of monitoring and control procedures, children and young people’s use of public spaces and places in parks, neighbourhoods, shopping malls and streets is often viewed as a threat to social order, requiring various forms of punitive and/or remedial action. Much of this civic action actively excludes some children and young people from participation and as a consequence, their trust in local processes and communities is eroded. This paper discusses worldwide developments in the surveillance, governance and control of the public space environments used by children and young people in particular and the capacity for their displacement and marginality, diminishing their sense of belonging, wellbeing and rights to public space as an expression of their social, political and civil citizenship(s).

People living in hilly residential areas in metropolitan Perth have less diabetes : spurious association or important environmental determinant?

BACKGROUND: Variations in 'slope' (how steep or flat the ground is) may be good for health. As walking up hills is a physiologically vigorous physical activity and can contribute to weight control, greater neighbourhood slopes may provide a protective barrier to weight gain, and help prevent Type 2 diabetes onset. We explored whether living in 'hilly' neighbourhoods was associated with diabetes prevalence among the Australian adult population. METHODS: Participants ([greater than or equal to]25years; n=11,406) who completed the Western Australian Health and Wellbeing Surveillance System Survey (2003-2009) were asked whether or not they had medically-diagnosed diabetes. Geographic Information Systems (GIS) software was used to calculate a neighbourhood mean slope score, and other built environment measures at 1600m around each participant's home. Logistic regression models were used to predict the odds of self-reported diabetes after progressive adjustment for individual measures (i.e., age, sex), socioeconomic status (i.e., education, income), built environment, destinations, nutrition, and amount of walking. RESULTS: After full adjustment, the odds of self-reported diabetes was 0.72 (95% CI 0.55-0.95) and 0.52 (95% CI 0.39-0.69) for adults living in neighbourhoods with moderate and higher levels of slope, respectively, compared with adults living in neighbourhoods with the lowest levels of slope. The odds of having diabetes was 13% lower (odds ratio 0.87; 95% CI 0.80-0.94) for each increase of one percent in mean slope. CONCLUSIONS: Living in a hilly neighbourhood may be protective of diabetes onset or this finding is spurious. Nevertheless, the results are promising and have implications for future research and the practice of flattening land in new housing developments.

Turbulence in an inundated urban environment during a major flood : implications in terms of people evacuation and sediment deposition

Floods through inundated urban environments constitute a hazard to the population and infrastructure. A series of field measurements were performed in an inundated section of the City of Brisbane (Australia) during a major flood in January 2011. Using an acoustic Doppler velocimeter (ADV), detailed velocity and suspended sediment concentration measurements were conducted about the peak of the flood. The results are discussed with a focus on the safety of individuals in floodwaters and the sediment deposition during the flood recession. The force of the floodwaters in Gardens Point Road was deemed unsafe for individual evacuation. A comparison with past laboratory results suggested that previous recommendations could be inappropriate and unsafe in real flood flows.

Early childhood education for sustainability : Queensland and Australian perspectives

Introduction Early childhood education for sustainability is an emerging field within education – a synthesis of early childhood education and education for sustainability. As a distinct field of educational inquiry and practice, it is less than 20 years old in Australia. My personal story is one that emerged from a background in primary school teaching where I worked in an Indigenous community teaching Aboriginal children. These experiences made me question the marginalization of Indigenous peoples in Australian society, the colonizing impacts of education, gave me deeper understandings of human-environment interactions, and the effects of poverty and powerlessness on options for Indigenous people both in Australia and elsewhere where peoples and their lands have been exploited. These teaching experiences took me back to university to undertake a degree in environmental studies to help me to better understand the nexus between society, environment and economy. Hence my background in education for sustainability comes as much from the social sciences as from the biological/ecological sciences...

Upper Darling: Brewarrina to Bourke : Talking fish - making connections with the rivers of the Murray-Darling Basin

To say ‘Back o’ Bourke’ means ‘miles from anywhere’ to most Australians, however the Barwon and Darling Rivers that pass by the townships of Brewarrina and Bourke, respectively, are at the heart of the Murray‐Darling Basin. These are the traditional lands of the Ngiyampaa, Murawari and Yuwalaraay peoples (refer Aboriginal language groups in the Bringing back the fish section at the back of this booklet). They fished the river and surrounding waterways and hunted the wetlands. The Ngiyampaa, Murawari and Yuwalaraay people have seen their land and the rivers change...

Ovens : Talking fish - making connections with the rivers of the Murray-Darling Basin

The Ovens River rises in the Victorian Alps where it is linked to significant freshwater meadows and marshes. It flows past Harrietville, Bright, Myrtleford and Wangaratta where it is joined by the King River on its way to meet the Murray near the top of Lake Mulwala. These the traditional lands of the Bangerang people and their neighbours the Taungurung and Yorta Yorta peoples. They have fished the river and surrounding waterways and hunted the wetlands. The ebb and flow of water guided their travels and featured in their stories. The Bangerang, Taungurung and Yorta Yorta have seen their land and the river change...

Sustainable creative career development pathways for young people in Tanzania : a case study

Tanzania has a rich and diverse cultural history based in community cultural life. However, at present, young people have limited opportunity to exploit this richness of traditional knowledge and engage in creative jobs as their means of future sustainable employment. Hence, the significant challenge remains: how to integrate and enhance the traditional knowledge in a learning strategy, while there is no “inter-ministerial action and institutional mechanisms” (United Nations 2008, 33-35) to promote creative employment for young people. This article reports on a case study that examined how the two Ministries of Culture and Education might work together to support Tanzania’s young people to secure, and engage successfully in creative jobs. The case study employed mixed methods, incorporating questionnaires, interviews and focus groups. The study was undertaken in Dar-Es-Salaam, Mwanza, Bagamoyo, Dodoma, Lindi and Morogoro from July to October, 2012. This paper discusses some of the issues and argues that there is no practical utilization of traditional knowledge and skills in “putting education to work” (UNESCO 2012, 170) for the better prospects of young people and to reveal the story of their lives. Although this study is specific to Tanzania, the case may also apply to other developing countries.

A randomized controlled trial of self-management programme improves health-related outcomes of older people with heart failure

Aims This paper is a report on the effectiveness of a self-management programme based on the self-efficacy construct, in older people with heart failure. Background Heart failure is a major health problem worldwide, with high mortality and morbidity, making it a leading cause of hospitalization. Heart failure is associated with a complex set of symptoms that arise from problems in fluid and sodium retention. Hence, managing salt and fluid intake is important and can be enhanced by improving patients' self-efficacy in changing their behaviour. Design Randomized controlled trial. Methods Heart failure patients attending cardiac clinics in northern Taiwan from October 2006–May 2007 were randomly assigned to two groups: control (n = 46) and intervention (n = 47). The intervention group received a 12-week self-management programme that emphasized self-monitoring of salt/fluid intake and heart failure-related symptoms. Data were collected at baseline as well as 4 and 12 weeks later. Data analysis to test the hypotheses used repeated-measures anova models. Results Participants who received the intervention programme had significantly better self-efficacy for salt and fluid control, self-management behaviour and their heart failure-related symptoms were significantly lower than participants in the control group. However, the two groups did not differ significantly in health service use. Conclusion The self-management programme improved self-efficacy for salt and fluid control, self-management behaviours, and decreased heart failure-related symptoms in older Taiwanese outpatients with heart failure. Nursing interventions to improve health-related outcomes for patients with heart failure should emphasize self-efficacy in the self-management of their disease.

Re-presenting the past : authenticity and the historical novel

This project involved writing Turrwan (great man), a novel set in Queensland in the nineteenth century, and an investigation into the way historical novels portray the past. Turrwan tells the story of Tom Petrie, who was six when he arrived with his family at the notorious Moreton Bay Penal Colony in 1837. The thesis examines historical fiction as a genre with particular focus on notions of historical authenticity. It analyses the complexities involved in a non-Indigenous person writing about the Australian Aboriginal people, and reflects on the process of researching, planning and writing a historical novel.