Development and feasibility testing of an education program to improve knowledge and self-care among Aboriginal and Torres Strait Islander patients with heart failure

Background/Aim There is a 70% higher age-adjusted incidence of heart failure (HF) amongst Aboriginal and Torres Strait Islander people, three times more hospitalisations and twice as many deaths than non-Aboriginal people. There is a need to develop holistic yet individualised approaches in accord with the values of Aboriginal community healthcare to support patient education and self-care. The aim of this study was to re-design an existing HF educational resource (Fluid Watchers-Pacific Rim©) to be culturally safe for Aboriginal and Torres Strait Islander peoples, working in collaboration with the local community, and to conduct feasibility testing. Methods This study was conducted in two phases and utilised a mixed methods approach (qualitative and quantitative). Phase 1 of this study used action research methods to develop a culturally safe electronic resource to be provided to Aboriginal HF patients via a tablet computer. A HF expert panel adapted the existing resource to ensure it was evidence-based and contained appropriate language and images that reflects Aboriginal culture. A stakeholder group (which included Aboriginal workers and HF patients, as well as researchers and clinicians) then reviewed the resources and changes were made accordingly. In Phase 2, the new resource was tested on a sample of Aboriginal HF patients to assess feasibility and acceptability. Patient knowledge, satisfaction and self-care behaviours were measured using a before and after design with validated questionnaires. As this was a pilot test to determine feasibility, no statistical comparisons were made. Results - Phase 1: Throughout the process of resource development, two main themes emerged from the stakeholder consultation. These were the importance of identity, meaning that it was important to ensure that the resource accurately reflected the local community, with the appropriate clothing, skin tone and voice. The resource was adapted to reflect this and of the local community voiced the recordings for the resource. The other theme was comprehension; images were important and all text was converted to the first person and used plain language. - Phase 2: Five Aboriginal participants, mean age 61.6 ± 10.0 years, with NYHA Class III and IV heart failure were enrolled. Participants reported a high level of satisfaction with the resource (83.0%). HF knowledge (percentage of correct responses) increased from 48.0 ± 6.7% to 58.0 ± 9.7%, a 20.8% increase and results of the self-care index indicated that the biggest change was in patient confidence for self-care with a 95% increase in confidence score (46.7 ± 16.0 to 91.1 ± 11.5). Changes in management and maintenance scores varied between9275 patients. Conclusion By working in collaboration with HF experts, Aboriginal researchers and patients, a culturally safe HF resource has been developed for Aboriginal and Torres Strait Islander patients. Engaging Aboriginal researchers, capacity-building, and being responsive to local systems and structures enabled this pilot study to be successfully completed with the Aboriginal community and positive participant feedback demonstrated that the methodology used in this study was appropriate and acceptable; participants were able to engage with willingness and confidence.

Effects of climate change on reproduction,larval development, and adult health of coral trout (Plectropomus spp.)

Climate change is emerging as the single greatest threat to coral-reef ecosystems.The most immediate impacts will be a loss of diversity and changes to fish community composition and may lead to eventual declines in abundance and productivity of key fisheries species. A key component of this research is to assess effects of projected changes in environmental conditions (temperature and ocean acidity) due to climate change on reproduction, growth and development of coral trout (Plectropomus leopardis).Ultimately, this research will fill key knowledge gaps about climate change impacts on larger fishes, which are fundamental to optimizing resilience-based management, and in turn improve the adaptive capacity of industries and communities along the Great Barrier Reef.

Sustainable Beef Industry Improvement and Innovation

This project ensures Queensland's involvement in Beef CRC Project 5.4 Accelerated Adoption through Sustainable Beef Profit Partnerships (BPP). The project researches, develops and achieves measurable improvements in business and industry productivity, profit and efficiency.

Advanced practice: A survey of current perspectives of Australian pharmacists

Background An Advanced Pharmacy Practice Framework for Australia (the ‘APPF’) was published in October 2012. Further to the release of the APPF, the Advanced Pharmacy Practice Framework Steering Committee planned to develop an advanced practice recognition model for Australian pharmacists. Aim To gauge the perspectives of the pharmacy profession relating to advanced practice, via an online survey, in order to inform the design of the model. Method A survey was developed and administered to Australian pharmacists through SurveyMonkey . The survey content was based on findings from a review of national and international initiatives for recognition of advanced practice in pharmacy and other health disciplines, including medicine and nursing. Results The results of the survey showed that a high proportion of respondents considered they were already working at, or working towards achieving, an advanced level of practice. The responses relating to the assessment methods showed a clear preference for ‘submission of a professional portfolio’. A ‘written examination’ had a low level of support and in relation to an ‘oral examination by a panel’ there was a marked preference for a panel of multidisciplinary health professionals over a panel of pharmacists. Conclusion The survey outcomes will inform the development of an advanced pharmacy practice recognition model for Australian pharmacists, particularly in relation to the assessment methods. Survey outcomes also demonstrated that there is scope to further enhance the application of the APPF in the development and recognition of advanced practitioners, and to build greater awareness of the breadth of competencies encompassed by ‘advanced practice’.

An Advanced Pharmacy Practice Framework for Australia

The need to develop An Advanced Pharmacy Practice Framework for Australia (the “APPF”) was identified during the 2010 review of the competency standards for Australian pharmacists. The Advanced Pharmacy Practice Framework Steering Committee, a collaborative profession-wide committee comprised of representatives of ten pharmacy organisations, examined and adapted existing advanced practice frameworks, all of which were found to have been based on the Competency Development and Evaluation Group (CoDEG) Advanced and Consultant Level Framework (the “CoDEG Framework”) from the United Kingdom. Its competency standards were also found to align well with the Domains of the National Competency Standards Framework for Pharmacists in Australia (the “National Framework”). Adaptation of the CoDEG Framework created an APPF that is complementary to the National Framework, sufficiently flexible to customise for recognising advanced practice in any area of professional practice and has been approved by the boards/councils of all participating organisations. The primary purpose of the APPF is to assist the development of the profession to meet the changing health care needs of the community. However, it is also a valuable tool for assuring members of the public of the competence of an advanced practice pharmacist and the quality and safety of the services they deliver.

The Application of Near Infrared Spectroscopy for the Assessment of Avocado Quality Attributes, Infrared Spectroscopy. Chapter 14

Quality and safety evaluation of agricultural products has become an increasingly important consideration in market/commercial viability and systems for such evaluations are now demanded by customers, including distributors and retailers. Unfortunately, most horticultural products struggle with delivering adequate and consistent quality to the consumer. Removing inconsistencies and providing what the consumer expects is a key factor for retaining and expanding both domestic and international markets. Most commercial quality classification systems for fruit and vegetables are based on external features of the product, for example: shape, colour, size, weight and blemishes. However, the external appearance of most fruit is generally not an accurate guide to the internal or eating quality of the fruit. Internal quality of fruit is currently subjectively judged on attributes such as volatiles, firmness, and appearance. Destructive subjective measures such as internal flesh colour, or objective measures such as extraction of juice to measure sweetness (oBrix) or assessment of dry matter (DM) content are also used, although obviously not for every fruit – just a sample to represent the whole consignment. For avocado fruit, external colour is not a maturity characteristic, and its smell is too weak and appears later in its maturity stage (Gaete-Garreton et al., 2005). Since maturity is a major component of avocado quality and palatability, it is important to harvest mature fruit, so as to ensure that fruit will ripen properly and have acceptable eating quality. Currently, commercial avocado maturity estimation is based on destructive assessment of the %DM, and sometimes percent oil, both of which are highly correlated with maturity (Clark et al., 2003; Mizrach & Flitsanov, 1999). Avocados Australia Limited (AAL (2008)) recommend a minimum maturity standard for its growers of 23 %DM (greater than 10% oil content) for the ‘Hass’ cultivar, although consumer studies indicate a preference for at least 25 %DM (Harker et al., 2007).

Modeling population growth and site specific control of the invasive Lantana camara L. (Verbenaceae) under differing fire regimes

It is at the population level that an invasion either fails or succeeds. Lantana camara L. (Verbenaceae) is a weed of great significance in Queensland Australia and globally but its whole life-history ecology is poorly known. Here we used 3 years of field data across four land use types (farm, hoop pine plantation and two open eucalyptus forests, including one with a triennial fire regime) to parameterise the weed’s vital rates and develop size-structured matrix models. Lantana camara in its re-colonization phase, as observed in the recently cleared hoop pine plantation, was projected to increase more rapidly (annual growth rate, λ = 3.80) than at the other three sites (λ 1.88–2.71). Elasticity analyses indicated that growth contributed more (64.6 %) to λ than fecundity (18.5 %) or survival (15.5 %), while across size groups, the contribution was of the order: juvenile (19–27 %) ≥ seed (17–28 %) ≥ seedling (16–25 %) > small adult (4–26 %) ≥ medium adult (7–20 %) > large adult (0–20 %). From a control perspective it is difficult to determine a single weak point in the life cycle of lantana that might be exploited to reduce growth below a sustaining rate. The triennial fire regime applied did not alter the population elasticity structure nor resulted in local control of the weed. However, simulations showed that, except for the farm population, periodic burning could work within 4–10 years for control of the weed, but fire frequency should increase to at least once every 2 years. For the farm, site-specific control may be achieved by 15 years if the biennial fire frequency is tempered with increased burning intensity.

Cat's claw creeper vine, Macfadyena unguis-cati (Bignoniaceae), invasion impacts: comparative leaf nutrient content and effects on soil physicochemical properties

Macfadyena unguis-cati (L.) Gentry (Bignoniaceae) is a major environmental weed in coastal Queensland, Australia. There is a lack of quantitative data on its leaf chemistry and its impact on soil properties. Soils from infested vs uninfested areas, and leaves of M. unguis-cati and three co-occurring vine species (one exotic, two native) were collected at six sites (riparian and non-riparian) in south-eastern Queensland. Effects of invasion status, species, site and habitat type were examined using univariate and multivariate analyses. Habitat type had a greater effect on soil nutrients than on leaf chemistry. Invasion effect of M. unguis-cati on soil chemistry was more pronounced in non-riparian than in riparian habitat. Significantly higher values were obtained in M. unguis-cati infested (vs. uninfested) soils for ~50% of traits. Leaf ion concentrations differed significantly between exotic and native vines. Observed higher leaf-nutrient load (especially nitrogen, phosphorus and potassium) in exotic plants aligns with the preference of invasive plant species for disturbed habitats with higher nutrient input. Higher load of trace elements (aluminium, boron, cadmium and iron) in its leaves suggests that cycling of heavy-metal ions, many of which are potentially toxic at excess level, could be accelerated in soils of M. unguis-cati-invaded landscape. Although inferences from the present study are based on correlative data, the consistency of the patterns across many sites suggests that M. unguis-cati may improve soil fertility and influence nutrient cycling, perhaps through legacy effects of its own litter input.

Patterns of seed bank and size asymmetry of plant growth across varying sites in the invasive Lantana camara L. (Verbenaceae)

Lantana camara L. (Verbenaceae) is a weed of great significance in Australia and worldwide, but little is known about connections among components of its life history. We document over a 3-year period, the links between L. camara seed-bank dynamics and its above-ground growth, including size asymmetry in four land-use types (a farm, a hoop pine plantation and two open eucalypt forests) invaded by the weed near Brisbane, Queensland Australia. Seed-bank populations varied appreciably across sites and in response to rainfall and control measures, and they were higher (~1,000 seeds/m2) when annual rainfall was 15-30 % below the long-term yearly average. Fire reduced seed-bank populations but not the proportion germinating (6-8 %). Nearly a quarter of fresh seeds remain germinable after 3 years of soil burial. For small seedlings (<10 cm high), the expected trade-offs in two life-history traits-survival and growth-did not apply; rather the observed positive association between these two traits, coupled with a persistent seed-bank population could contribute to the invasiveness of the plant. Relationships between absolute growth rate and initial plant size (crown volume) were positively linear, suggesting that most populations are still at varying stages of the exponential phase of the sigmoid growth; this trend also suggests that at most sites and despite increasing stand density and limiting environmental resources of light and soil moisture, lantana growth is inversely size asymmetric. From the observed changes in measures of plant size inequality, asymmetric competition appeared limited in all the infestations surveyed. © 2013 Crown Copyright as represented by: Department of Agriculture, Fisheries and Forestry, Australia.

A Paddock to reef monitoring and modelling framework for the Great Barrier Reef: Paddock and catchment component

Targets for improvements in water quality entering the Great Barrier Reef (GBR) have been set through the Reef Water Quality Protection Plan (Reef Plan). To measure and report on progress towards the targets set a program has been established that combines monitoring and modelling at paddock through to catchment and reef scales; the Paddock to Reef Integrated Monitoring, Modelling and Reporting Program (Paddock to Reef Program). This program aims to provide evidence of links between land management activities, water quality and reef health. Five lines of evidence are used: the effectiveness of management practices to improve water quality; the prevalence of management practice adoption and change in catchment indicators; long-term monitoring of catchment water quality; paddock & catchment modelling to provide a relative assessment of progress towards meeting targets; and finally marine monitoring of GBR water quality and reef ecosystem health. This paper outlines the first four lines of evidence. (C) 2011 Elsevier Ltd. All rights reserved.

A lifespan perspective on leadership

In this chapter, we present a lifespan model of leadership that outlines how leader and follower age as well as age-related changes in leader traits and characteristics, leader behaviors, and follower attribution and identification processes may influence leadership effectiveness. First, we describe how leader traits and characteristics change with age and how these developmental changes may impact on leader behaviors and, subsequently, leadership effectiveness. Specifically, we discuss age-related changes in leaders’ task competence, interpersonal attributes, and motivation to lead. We particularly focus on how generativity – a set of interconnected motives pertaining to establishing and guiding future generations – may emerge as an important concern among older leaders. Second, we review theoretical approaches that help explain how and why leader age and age-related traits and characteristics, follower age, as well as leader-follower age differences may influence follower attribution and identification processes. Third, we outline a number of boundary conditions of the effects proposed by our lifespan model of leadership, including leader-follower relationship duration, situational characteristics, as well as the cultural, social, and historical context. We conclude the chapter by discussing our model’s implications for future research and organizational practice.

Nine year changes in sitting time in young and mid-aged Australian women: Findings from the Australian longitudinal study for women's health

- Objective To examine changes in sitting time (ST) in women over nine years and to identify associations between life events and these changes. - Methods Young (born 1973–78, n = 5215) and mid-aged (born 1946–51, n = 6973) women reported life events and ST in four surveys of the Australian Longitudinal Study on Women's Health between 2000 and 2010. Associations between life events and changes in ST between surveys (decreasers ≥ 2 h/day less, increasers ≥ 2 h/day more) were estimated using generalized estimating equations. - Results Against a background of complex changes there was an overall decrease in ST in young women (median change − 0.48 h/day, interquartile range [IQR] = − 2.54, 1.50) and an increase in ST in mid-aged women (median change 0.43 h/day; IQR = − 1.29, 2.0) over nine years. In young women, returning to study and job loss were associated with increased ST, while having a baby, beginning work and decreased income were associated with decreased ST. In mid-aged women, changes at work were associated with increased ST, while retiring and decreased income were associated with decreased ST. - Conclusions ST changed over nine years in young and mid-aged Australian women. The life events they experienced, particularly events related to work and family, were associated with these changes.

Validity of a self-report recall tool for estimating sedentary behaviour in adults

BACKGROUND Sedentary behavior is continuing to emerge as an important target for health promotion. The purpose of this study was to determine the validity of a self-report use of time recall tool, the Multimedia Activity Recall for Children and Adults (MARCA) in estimating time spent sitting/lying, compared with a device-based measure. METHODS Fifty-eight participants (48% female, [mean±standard deviation] 28±7.4 years of age, 23.9±3.05 kg/m2) wore an activPAL device for 24-h and the following day completed the MARCA. Pearson correlation coefficients (r) were used to analyse convergent validity of the adult MARCA compared with activPAL estimates of total sitting/lying time. Agreement was examined using Bland-Altman plots. RESULTS According to activPAL estimates, participants spent 10.4 hr/day [standard deviation (SD)=2.06] sitting or lying down while awake. The correlation between MARCA and activPAL estimates of total sit/lie time was r=0.77 (95% confidence interval = 0.64-0.86; p<0.001). Bland-Altman analyses revealed a mean bias of +0.59 hr/day with moderately wide limits of agreement (-2.35 hours to +3.53 hr/day). CONCLUSIONS This study found a moderate to strong agreement between the adult MARCA and the activPAL, suggesting that the MARCA is an appropriate tool for the measurement of time spent sitting or lying down in an adult population.