Mobility and active ageing in suburban environments : findings from in-depth interviews and person-based GPS tracking

Background. Governments face a significant challenge to ensure that community environments meet the mobility needs of an ageing population. Therefore, it is critical to investigate the effect of suburban environments on the choice of transportation and its relation to participation and active ageing. Objective. This research explores if and how suburban environments impact older people’s mobility and their use of different modes of transport. Methods. Data derived from GPS tracking, travel diaries, brief questionnaires, and semistructured interviews were gathered from thirteen people aged from 56 to 87 years, living in low-density suburban environments in Brisbane, Australia. Results. The suburban environment influenced the choice of transportation and out-of-home mobility. Both walkability and public transportation (access and usability) impact older people’s transportation choices. Impracticality of active and public transportation within suburban environments creates car dependency in older age. Conclusion. Suburban environments often create barriers to mobility, which impedes older people’s engagement in their wider community and ability to actively age in place. Further research is needed to develop approaches towards age-friendly suburban environments which will encourage older people to remain active and engaged in older age.

Suspected child abuse and neglect reporting behaviour

Executuve Summary Background and Aims Child abuse and neglect is a tragedy within our community, with over 10,000 substantiated reports of abuse and neglect in Queensland in the past year. The considerable consequences of child abuse and neglect are far-reaching, substantial and can be fatal. The reporting of suspicions of child abuse or neglect is often the first step in preventing further abuse or neglect. In the State of Queensland, medical practitioners are mandated by law to report their suspicions of child abuse and neglect. However, despite this mandate many still do not report their suspicions. A 1998 study indicated that 43% of medical practitioners had, at some time, made a conscious decision to not report suspected abuse or neglect (Van Haeringen, Dadds & Armstrong, 1998). The aim of this study was to gain a better understanding of beliefs about reporting suspected child abuse and neglect and the barriers to reporting suspected abuse and neglect by medical practitioners and parents and students. The findings have the potential to inform the training and education of members of the community who have a shared responsibility to protect the wellbeing of its most vulnerable members. Method In one of the largest studies of reporting behaviour in relation to suspected child abuse and neglect in Australia, we examined and compared medical practitioners’ responses with members of the community, namely parents and students. We surveyed 91 medical practitioners and 214 members of the community (102 parents and 112 students) regarding their beliefs and reporting behaviour related to suspected child abuse and neglect. We also examined reasons for not reporting suspected abuse or neglect, as well as awareness of responsibilities and the appropriate reporting procedures. To obtain such information, participants anonymously completed a comprehensive questionnaire using items from previous studies of reporting attitudes and behaviour. Executive Summary Abused Child Trust Report August 2003 5 Findings Key findings include: • The majority of medical practitioners (97%) were aware of their duty to report suspected abuse and neglect and believed they had a professional and ethical duty to do so. • A majority of parents (82%) and students (68%) also believed that they had a professional and ethical duty to report suspected abuse and neglect. • In accord with their statutory duty to report suspected abuse and neglect, 69% of medical practitioners had made a report at some point. • Sixteen percent of parents and 9% of students surveyed indicated that they had reported their suspicions of neglect and abuse. • The most endorsed belief associated with not reporting suspected child abuse and neglect was that, ‘unpleasant events would follow reporting’. • Over a quarter of medical practitioners (26%) admitted to making a decision not to report their suspicions of child abuse or neglect on at least one occasion. • Compared with previous research, there has been a decline in the number of medical practitioners who decided not to report suspected abuse or neglect from 43% (Van Haeringen et al., 1998) to 26% in the current study. • Fourteen percent of parents and 15% of students surveyed had also chosen not to report a case of suspected abuse or neglect. • Attitudes that most strongly influenced the decision to report or not report suspected abuse or neglect differed between groups (medical practitioners, parents, or students). A belief that, ‘the abuse was a single incident’ was the best predictor of non-reporting by medical practitioners, while having ‘no time to follow-up the report’ or failing to be ‘convinced of evidence of abuse’ best predicted failure to report abuse by students. A range of beliefs predicted non-reporting by parents, including the beliefs that reporting suspected abuse was ‘not their responsibility’ and ‘knowing the child had retracted their statement’. Conclusions Of major concern is that approximately 25% of medical practitioners with a mandated responsibility to report, as well as some members of the general public, revealed that they have suspected child neglect or abuse but have made the decision not to report their suspicions. Parents and students perceived the general community as having responsibility for reporting suspicions of abuse or neglect. Despite this perception, they felt that lodging a report may be overly demanding in terms of time and they had the confidence in their ability to identify child abuse and neglect. An explanation for medical practitioners deciding not to report may be based upon their optimistic belief that suspected abuse or neglect was a single incident. Our findings may best be understood from the ‘inflation of optimism’ hypothesis put forward by the Nobel Laureate, Daniel Kahneman. He suggests that in spite of rational evidence, human beings tend to make judgements based on an optimistic view rather than engaging in a rational decision-making process. In this case, despite past behaviour of abuse or neglect being the best predictor of future behaviour, medical practitioners have taken an optimistic view, choosing to believe that their suspicion of child abuse or neglect represents a single incident. The clear implication of findings in the current research is the need for the members of the general community and medical practitioners to be better appraised of the consequences of their decision-making in relation to suspicionsof child abuse and neglect. Finally findings from parents and students relating to their reporting behaviour suggest that members of the larger community represent an untapped resourcewho might, with appropriate awareness, play a more significant role in theidentification and reporting of suspected child abuse and neglect.

The impact of surgical ward nurses practicing respiratory assessment on positive patient outcomes

Objective: A literature review to examine the incorporation of respiratory assessment into everyday surgical nursing practice; possible barriers to this; and the relationship to patient outcomes. Primary argument: Escalating demands on intensive care beds have led to highly dependent patients being cared for in general surgical ward areas. This change in patient demographics has meant the knowledge and skills required of registered nurses in these areas has expanded exponentially. The literature supported the notion that postoperative monitoring of vital signs should include the fundamental assessment of respiratory rate; depth and rhythm; work of breathing; use of accessory muscles and symmetrical chest movement; as well as auscultation of lung fields using a stethoscope. Early intervention in response to changes in a patient's respiratory health status impacts positively on patient health outcomes. Substantial support exists for the contention that technologically adept nurses who also possess competent respiratory assessment skills make a difference to respiratory care. Conclusions: Sub-clinical respiratory problems have been demonstrated to contribute to adverse events. There is a paucity of research knowledge as to whether respiratory education programs and associated inservice make a difference to nursing clinical practice. Similarly, the implications for associated respiratory educational needs are not well documented, nor has a research base been sufficiently developed to guide nursing practice. Further research has the potential to influence the future role and function of the registered nurse by determining the importance of respiratory education programs on post-operative patient outcomes.

Information support for health management in regional Sri Lanka : health managers’ perspectives

Good management, supported by accurate, timely and reliable health information, is vital for increasing the effectiveness of Health Information Systems (HIS). When it comes to managing the under resourced health systems of developing countries, information-based decision making is particularly important. This paper reports findings of a self-report survey that investigated perceptions of local health managers (HMs) of their own regional HIS in Sri Lanka. Data were collected through a validated, pre-tested postal questionnaire, and distributed among a selected group of HMs to elicit their perceptions of the current HIS in relation to information generation, acquisition and use, required reforms to the information system and application of information and communication technology (ICT). Results based on descriptive statistics indicated that the regional HIS was poorly organised and in need of reform; that management support for the system was unsatisfactory in terms of relevance, accuracy, timeliness and accessibility; that political pressure and community and donor requests took precedence over vital health information when management decisions were made; and use of ICT was unsatisfactory. HIS strengths included user-friendly paper formats, a centralised planning system and an efficient disease notification system; weaknesses were lack of comprehensiveness, inaccuracy, and lack of a feedback system. Responses of participants indicated that HIS would be improved by adopting an internationally accepted framework and introducing ICT applications. Perceived barriers to such improvements were high initial cost of educating staff to improve computer literacy, introduction of ICTs, and HIS restructure. We concluded that the regional HIS of Central Province, Sri Lanka had failed to provide much needed information support to HMs. These findings are consistent with similar research in other developing countries and reinforce the need for further research to verify causes of poor performance and to design strategic reforms to improve HIS in regional Sri Lanka.

How much do residential aged care staff members know about the nutritional needs of residents?

Background Undernutrition, weight loss and dehydration are major clinical issues for people with dementia in residential care, with excessive weight loss contributing to increased risk of frailty, immobility, illness and premature morbidity. This paper discusses a nutritional knowledge and attitudes survey conducted as part of a larger project focused on improving nutritional intake of people with dementia within a residential care facility in Brisbane, Australia. Aims The specific aims of the survey were to identify (i) knowledge of the nutritional needs of aged care facility residents; (ii) mealtime practices; and (iii) attitudes towards mealtime practices and organisation. Methods A survey based on those used in other healthcare settings was completed by 76 staff members. The survey included questions about nutritional knowledge, opinions of the food service, frequency of feeding assistance provided and feeding assessment practices. Results Nutritional knowledge scores ranged from 1 to 9 of a possible 10, with a mean score of 4.67. While 76% of respondents correctly identified risk factors associated with malnutrition in nursing home residents, only 38% of participants correctly identified the need for increased protein and energy in residents with pressure ulcers, and just 15% exhibited correct knowledge of fluid requirements. Further, while nutritional assessment was considered an important part of practice by 83% of respondents, just 53% indicated that they actually carried out such assessments. Identified barriers to promoting optimal nutrition included insufficient time to observe residents (56%); being unaware of residents' feeding issues (46%); poor knowledge of nutritional assessments (44%); and unappetising appearance of food served (57%). Conclusion An important step towards improving health and quality of life for residents of aged care facilities would be to enhance staff nutritional awareness and assessment skills. This should be carried out through increased attention to both preservice curricula and on-the-job training. Implications for practice The residential facility staff surveyed demonstrated low levels of nutrition knowledge, which reflects findings from the international literature. This has implications for the provision of responsive care to residents of these facilities and should be explored further.

Knowing our users: scoping interviews in design research with ageing participants

This paper reports the findings from a series of scoping interviews designed to evaluate, ground and refine the initial understandings, assumptions and concepts of a research team in a larger project about the role of social and tangible technologies in maintaining good habits into old age. Participants' understandings of some basic terms used in the research are presented along with a discussion of their current use of new and established information and communications technologies and the existing barriers to ongoing uptake of emerging technologies. The findings suggest that we question common assumptions about both ageing and technology usage by ageing people, demonstrating the contribution such early scoping interviews can make within design research projects.

Fostering wellbeing of immigrants and refugees? Evaluating the outcomes of work integration social enterprise

Work integration social enterprises (WISE) seek to create employment and pathways to employment for those highly disadvantaged in the labour market. This chapter examines the effects of WISE on the wellbeing of immigrants and refugees experiencing multiple barriers to economic and social participation. Drawing on an evaluation of a programme that supports seven such enterprises in the Australian state of Victoria, the effects of involvement for individual participants and their communities are examined. The study finds that this social enterprise model affords unique local opportunities for economic and social participation for groups experiencing significant barriers to meaningful employment. These opportunities have a positive impact on individual and community-level wellbeing. However, the financial costs of the model are high relative to other employment programmes, which is consistent with international findings on intermediate labour market programmes. The productivity costs of WISE are also disproportionately high compared to private sector competitors in some industries. This raises considerable dilemmas for social enterprise operators seeking to produce social value and achieve business sustainability while bearing high productivity costs to fulfil their mission. Further, the evaluation illuminates an ongoing need to address the systemic and structural drivers of health and labour market inequalities that characterize socio-economic participation for immigrants and refugees.

The influence of parental health beliefs on child restraint practices in a regional centre in Queensland

Since March 2010 in Queensland, legislation has specified the type of restraint and seating row for child passengers under 7 years according to age. The following study explored regional parents’ child restraint practices and the influence of their health beliefs over these. A brief intercept interview was verbally administered to a convenience sample of parent-drivers (n = 123) in Toowoomba in February 2010, after the announcement of changes to legislation but prior to enforcement. Parents who agreed to be followed-up were then reinterviewed after the enforcement (May-June 2010). The Health Beliefs Model was used to gauge beliefs about susceptibility to crashing, children being injured in a crash, and likely severity of injuries. Self-efficacy and perceptions about barriers to, and benefits of, using age-appropriate restraints with children, were also assessed. Results: There were very high levels of rear seating reported for children (initial interview 91%; follow-up 100%). Dedicated child restraint use was 96.9% at initial interview, though 11% were deemed inappropriate for the child’s age. Self-reported restraint practices for children under 7 were used to categorise parental practices into ‘Appropriate’ (all children in age-appropriate restraint and rear seat) or ‘Inappropriate’ (≥1 child inappropriately restrained). 94% of parents were aware of the legislation, but only around one third gave accurate descriptions of the requirements. However, 89% of parents were deemed to have ‘Appropriate’ restraint practices. Parents with ‘Inappropriate’ practices were significantly more likely than those with ‘Appropriate’ practices to disagree that child restraints provide better protection for children in a crash than adult seatbelts. For self-efficacy, parents with ‘Appropriate’ practices were more likely than those with ‘Inappropriate’ practices to report being ‘completely confident’ about installing child restraints. The results suggest that efforts to increase the level of appropriate restraint should attempt to better inform them about the superior protection offered by child restraints compared with seat belts for children.

Animating and sustaining niche social networks

Within the communicative space online Social Network Sites (SNS) afford, Niche Social Networks Sites (NSNS) have emerged around particular geographic, demographic or topic-based communities to provide what broader SNS do not: specified and targeted content for an engaged and interested community. Drawing on a research project developed at the Queensland University of Technology in conjunction with the Australian Smart Services Cooperative Research Centre that produced an NSNS based around Adventure Travel, this paper outlines the main drivers for community creation and sustainability within NSNS. The paper asks what factors motivate users to join and stay with these sites and what, if any, common patterns can be noted in their formation. It also outlines the main barriers to online participation and content creation in NSNS, and the similarities and differences in SNS and NSNS business models. Having built a community of 100 registered members, the staywild.com.au project was a living laboratory, enabling us to document the steps taken in producing a NSNS and cultivating and retaining active contributors. The paper incorporates observational analysis of user-generated content (UGC) and user profile submissions, statistical analysis of site usage, and findings from a survey of our membership pool in noting areas of success and of failure. In drawing on our project in this way we provide a template for future iterations of NSNS initiation and development across various other social settings: not only niche communities, but also the media and advertising with which they engage and interact. Positioned within the context of online user participation and UGC research, our paper concludes with a discussion of the ways in which the tools afforded by NSNS extend earlier understandings of online ‘communities of interest’. It also outlines the relevance of our research to larger questions about the diversity of the social media ecology.

A basis for inquiry into policy considerations for increasing the application of biophilic urbanism

Urban design that harnesses natural features (such as green roofs and green walls) to improve design outcomes is gaining significant interest, particularly as there is growing evidence of links between human health and wellbeing, and contact with nature. The use of such natural features can provide many significant benefits, such as reduced urban heat island effects, reduced peak energy demand for building cooling, enhanced stormwater attenuation and management, and reduced air pollution and greenhouse gas emissions. The principle of harnessing natural features as functional design elements, particularly in buildings, is becoming known as ‘biophilic urbanism’. Given the potential for global application and benefits for cities from biophilic urbanism, and the growing number of successful examples of this, it is timely to develop enabling policies that help overcome current barriers to implementation. This paper describes a basis for inquiry into policy considerations related to increasing the application of biophilic urbanism. The paper draws on research undertaken as part of the Sustainable Built Environment National Research Centre (SBEnrc) In Australia in partnership with the Western Australian Department of Finance, Parsons Brinckerhoff, Green Roofs Australasia, and Townsville City Council (CitySolar Program). The paper discusses the emergence of a qualitative, mixed-method approach that combines an extensive literature review, stakeholder workshops and interviews, and a detailed study of leading case studies. It highlights the importance of experiential and contextual learnings to inform biophilic urbanism and provides a structure to distil such learnings to benefit other applications.

The emerging role of the Board of Directors in enterprise business technology governance

In an increasingly business technology (BT) dependent world, the impact of the extraordinary changes brought about by the nexus of mobile and cloud technologies, social media and big data is increasingly being felt in the board room. As leaders of enterprises of every type and size, board directors can no longer afford to ignore, delegate or avoid BT-related decisions. Competitive, financial and reputational risk is increased if boards fail to recognize their role in governing technology as an asset and in removing barriers to improving enterprise business technology governance (EBTG). Directors’ awareness of the need for EBTG is increasing. However, industry research shows that board level willingness to rectify the gap between awareness and action is very low or non-existent. This literature review-based research identifies barriers to EBTG effectiveness. It provides a practical starting point for board analysis. We offer four outcomes that boards might focus on to ensure the organizations they govern are not left behind by those led by the upcoming new breed of technology-savvy leaders. Most extant research looks backward for examples, examining data pre-2010, the time when a tipping point in the personal and business use of multimedia and mobile-internet devices significantly deepened the impacts of the identified nexus technology forces, and began rapidly changing the way many businesses engage with their customers, employees and stakeholders. We situate our work amidst these nexus forces, discuss the board’s role in EBTG in this context, and modernize current definitions of enterprise technology governance. The primary limitation faced is the lack of scholarly research relating to EBTG in the rapidly changing digital economy. Although we have used recent (2011 - 2013) industry surveys, the volume of these surveys and congruence across them is significant in terms of levels of increased awareness and calls for increased board attention and competency in EBTG and strategic information use. Where possible we have used scholarly research to illustrate or discuss industry findings.

Cancer-related psychosocial research : what are the perspectives of cancer care centre users on participation?

Purpose To explore the perspectives of cancer care centre users on participation in psychosocial research to inform research design and ethics. Methods The study is based on a qualitative research design. Fourteen semistructured interviews were carried in people diagnosed with cancer and carers. The interview included four main questions about practical barriers to participation, types of research design, motivating factors and the conduct of research in a cancer care support setting. The data were analysed using qualitative content analysis. Results Interviewees demonstrated a willingness to participate in psychosocial research within certain circumstances. There were no practical barriers identified, although they considered payment for research-related travel important. The most acceptable research design was the face-to-face interview and the least preferred was the randomised control trial. The factors that motivated participation were altruism, valuing research, and making a contribution to the centre. Interviewees supported the conduct of research in cancer care support centres conditional upon delaying recruitment during the initial months of users’ visits and its need to be discreet to avoid deterring visitors from accessing the centre. Conclusions The study concludes that the personal interaction between participants and researchers is the most important feature of decision-making by patients/carers to join studies. Taking into account the perspectives of people affected by cancer during the early stages of research design may enhance recruitment and retention and can contribute to the development of research protocols and ethics.

What are the health needs, familial and social problems of Thai migrants in a local community in Australia? A focus group study

This study explored the health needs, familial and social problems of Thai migrants in a local community in Brisbane, Australia. Five focus groups with Thai migrants were conducted. The qualitative data were examined using thematic content analysis that is specifically designed for focus group analysis. Four themes were identified: (1) positive experiences in Australia, (2) physical health problems, (3) mental health problems, and (4) familial and social health problems. This study revealed key health needs related to chronic disease and mental health, major barriers to health service use, such as language skills, and facilitating factors, such as the Thai Temple. We concluded that because the health needs, familial and social problems of Thai migrants were complex and culture bound, the development of health and community services for Thai migrants needs to take account of the ways in which Thai culture both negatively impacts health and offer positive solutions to problems.

Delphi study for improving sustainable construction project management in universities

As sustainability becomes an important principle guiding various human activities around the globe, the higher education sector is being asked to take an active part in educating and promoting sustainability due to its moral responsibility, social obligation and its own needs to adapt to new circumstances. There is a global trend of higher education institutions embarking on responses to the sustainability challenge. On-campus building performance is one of the most important indicators for “sustainable universities”, because buildings carry substantially environmental burden such as considerable consumption of raw materials and energy as well as huge amount of waste generation and greenhouse gas emission. Plus, much research proves that building performance can impact on students and staff’s awareness about and behaviours related to sustainability. The past studies rarely discussed about sustainable construction projects in universities’ unique context. Universities are labeled with distinct characteristics such as complex governance, multiple cultures and juggling missions and so on. It is necessary and meaningful to examine the project management system in terms of universities’ organizational environment. Thus, this research project applies Delphi study to identify primary barriers to green technology application in on-campus buildings, critical factors for sustainable project success, key actions in project phases and strategies for project improvement. Through three rounds of questionnaires among panel experts, the authors obtain a profound understanding of project delivery system in universities. The research results are expected to provide sustainability practitioners with holistic understanding and generic information about sustainable construction project performance on campus as an assistance tool.

The influence of human rights on land rights and spatial information

This paper reviews the growing influence of human rights issues on land rights, administration, management and tenure. In the last few decades, attention focussed on integrating economic and environmental considerations to achieve sustainable land use. The World Trade Organisation began in 1995. As a condition of membership, nations undertook legislative programmes aimed at reducing price distortions and barriers to international trade. Reducing trade barriers has direct effects on agricultural production as a major land use. Similarly, as signatories to the 1992 Rio Declaration, nations undertook caring for and reporting on the state of the environment. However, quality of life is also an issue in deciding what is sustainable development. The Universal Declaration of Human Rights, proclaimed in 1948, provided a framework for a series of international human rights conventions. These conventions now influence national legislative programmes. The purpose of this paper is to review some of the implications of human rights on rights in land and the production and use of spatial information.