Multiple perspectives on quality of life for residents with dementia in long term care facilities: Protocol for a comprehensive Australian study

Background Dementia is a chronic illness without cure or effective treatment, which results in declining mental and physical function and assistance from others to manage activities of daily living. Many people with dementia live in long term care facilities, yet research into their quality of life (QoL) was rare until the last decade. Previous studies failed to incorporate important variables related to the facility and care provision or to look closely at the daily lives of residents. This paper presents a protocol for a comprehensive, multi-perspective assessment of QoL of residents with dementia living in long term care in Australia. A secondary aim is investigating the effectiveness of self-report instruments for measuring QoL. Methods The study utilizes a descriptive, mixed methods design to examine how facility, care staff, and resident factors impact QoL. Over 500 residents with dementia from a stratified, random sample of 53 facilities are being recruited. A sub-sample of 12 residents is also taking part in qualitative interviews and observations. Conclusions This national study will provide a broad understanding of factors underlying QoL for residents with dementia in long term care. The present study uses a similar methodology to the US-based Collaborative Studies of Long Term Care (CS-LTC) Dementia Care Study, applying it to the Australian setting.

Design and evaluation of intentionally enriched awareness

In this chapter we introduce and explore the notion of “intentionally enriched awareness”. Intentional enrichment refers to the process of actively engaging users in the awareness process by enabling them to express intentions. We initially look at the phenomenon if sharing intentional information in related collaborative systems. We then explore the concept of intentional enrichment through designing and evaluating the AnyBiff system which allows users to freely create, share and use a variety of biff applications. Biffs are simple representation of pre-defined activities. Users can select biffs to indicate that they are engaged in an activity. We summarise the results of a trial which allowed us to gain insights into the potential of the AnyBiff prototype and the underlying biff concept to implement intentionally enriched awareness. Our findings show that intentional disclosure mechanisms in the form of biffs were successfully used in a variety of contexts. Users actively engaged in the design of a large variety of biffs and explored many different uses of the concept. The study revealed a whole host of issues with regard to intentionally enriched awareness which give valuable insight into the conception and design of future applications in this area.

Teachers-as-writers: Writing information texts in English and vernacular

Our contribution to this volume is not on the work of the teacher who inspires the child writer, but the teacher as the writer and illustrator of multilingual texts for classroom use that inspires the child reader. This chapter focuses on a first time teacher writer from Fiji, Bereta , who participated in a two day writing workshop known as the Information Text Awareness Project (hereafter ITAP). This chapter commences with an overview of the ITAP which was conducted in Nadi, Fiji, in 2012 with Bereta and 17 teachers from urban, semi-urban and rural contexts within the Nadi educational district. The politics of presenting Western ways of knowing to teachers from diverse cultural and linguistic contexts via a Western pedagogical approach is explored in the second section. We believe that this work involves a moral dimension that needs careful consideration. The third section outlines the eight stages of ITAP where teacher writers such as Bereta produced an English and a vernacular information text for use in their classrooms. The outline of the eight stages of ITAP is justified with links to the research literature. The final section recounts Bereta’s interview data where she talks about using the newly created English and vernacular information texts in the classroom and the community’s response to her inaugural publications. The findings may be of interest to those seeking to establish an adult writing cooperative to produce English and vernacular information texts for classroom use.

The Library beyond (just) the book: Collaboration and co-working spaces for new technology and new technological practices

Libraries have often been first adopters of many new technological innovations, such as, punch cards, computers, barcodes, and e-book readers. It is thus not surprising that many libraries have embraced the advent of the internet as an opportunity to move away from just being repositories of books, towards becoming ideas stores and local network hubs for entrepreneurial thinking and new creative practices. This presentation will look at the case of “The Edge” – an initiative of the State Library of Queensland in Brisbane, Australia, to establish a digital culture centre and learning environment deliberately designed for the co-creation and co-construction of knowledge. This initiative illustrates the potential role of libraries as testing grounds for new technologies and technological practices, which is particularly relevant in the context of the NBN rollout across Australia. It also provides an example of new engagement strategies for innovative co-working spaces that are a vital element in a trend that sees professionals, creatives and designers leave their traditional places of work and embrace the city as their office.

Ageing Australian unions and the ‘youth problem’

Trade union membership, both in aggregate numbers and in density, has declined in the majority of advanced economies globally over recent decades (Blanchflower, 2007). In Australia, the decline in the 1990s was somewhat more precipitate than in most countries (Peetz, 1998). As discussed in Chapter 1, reasons for the decline are multifactorial, including a more hostile environment to unionism created by employers and the state, difficulties ·with workplace union organisation, and structural change in the economy (Bryson and Gomez, 2005; Bryson et a!., 2011; Ebbinghaus et al., 2011; Payne, 1989; Waddington and Kerr, 2002; Waddington and Whitson, 1997). Our purpose in this chapter is to look beyond aggregate Australian union density data, to examine how age relates to membership decline, and how different age groups, particularly younger workers, are located in the story of union decline. The practical implications of this research are that understanding how unions relate to workers of different age groups, and to workers of different genders amongst those age groups, may lead to improved recruitment and better union organisation.

Environmental crime, human rights and green criminology

This chapter is concerned with the prospects for a safe and sustainable environment in a fair and just world. At present, these prospects look bleak. However there are a number of legal developments and ethical principles on which to build, including the European Convention on the Protection of the Environment through Criminal Law, notions of environmental, ecological and species justice, and conceptions of human rights. The chapter considers these in five sections: first providing an overview and exploring the links between human rights and environmental issues; then examining examples of environmental crimes / harms and attempts to regulate or criminalise these; before outlining the development of a Green Criminology and proposals for an international law against ecocide as a framework for addressing this range of challenges. Finally, concluding comments draw attention to debates and directions for discussion and research.

Advance care planning in stroke: Influence of time on engagement in the process

Purpose Individuals who experience stroke have a higher likelihood of subsequent stroke events, making it imperative to plan for future medical care. In the event of a further serious health event, engaging in the process of advanced care planning (ACP) can help family members and health care professionals (HCPs) make medical decisions for individuals who have lost the capacity to do so. Few studies have explored the views and experiences of patients with stroke about discussing their wishes and preferences for future medical events, and the extent to which stroke HCPs engage in conversations around planning for such events. In this study, we sought to understand how the process of ACP unfolded between HCPs and patients post-stroke. Patients and methods Using grounded theory (GT) methodology, we engaged in direct observation of HCP and patient interactions on an acute stroke unit and two stroke rehabilitation units. Using semi-structured interviews, 14 patients and four HCPs were interviewed directly about the ACP process. Results We found that open and continual ACP conversations were not taking place, patients experienced an apparent lack of urgency to engage in ACP, and HCPs were uncomfortable initiating ACP conversations due to the sensitive nature of the topic. Conclusion In this study, we identified lack of engagement in ACP post-stroke, attributable to patient and HCP factors. This encourages us to look further into the process of ACP in order to develop open communication between the patient with stroke, their families, and stroke HCPs.

Start making sense: Applying a salutogenic model to architectural design for psychiatric care

Purpose This paper aims to look into the significance of architectural design in psychiatric care facilities. There is a strong correlation between perceptual dysfunction and psychiatric illness, and also between the patient and his environment. As such, even minor design choices can be of great consequence in a psychiatric facility. It is of critical importance, therefore, that a psychiatric milieu is sympathetic and does not exacerbate the psychosis. Design/methodology/approach This paper analyses the architectural elements that may influence mental health, using an architectural extrapolation of Antonovsky’s salutogenic theory, which states that better health results from a state of mind which has a fortified sense of coherence. According to the theory, a sense of coherence is fostered by a patient’s ability to comprehend the environment (comprehensibility), to be effective in his actions (manageability) and to find meaning (meaningfullness). Findings Salutogenic theory can be extrapolated in an architectural context to inform design choices when designing for a stress-sensitive client base. Research limitations/implications In the paper an architectural extrapolation of salutogenic theory is presented as a practical method for making design decisions (in praxis) when evidence is not available. As demonstrated, the results appear to reflect what evidence is available, but real evidence is always desirable over rationalist speculation. The method suggested here cannot prove the efficacy or appropriateness of design decisions and is not intended to do so. Practical implications The design of mental health facilities has long been dominated by unsubstantiated policy and normative opinions that do not always serve the client population. This method establishes a practical theoretical model for generating architectural design guidelines for mental health facilities. Originality/value The paper will prove to be helpful in several ways. First, salutogenic theory is a useful framework for improving health outcomes, but in the past the theory has never been applied in a methodological way. Second, there have been few insights into how the architecture itself can improve the functionality of a mental health facility other than improve the secondary functions of hospital services.

Stand-out progress from our corporate first-movers

In May, the National Business Leaders Forum on Sustainable Development meets for the 10th time. More than ever business leadership is needed to help us all address the challenges around climate change, water availability and species loss. Here’s a quick look at some committed corporate stars...

Genetic and environmental influences on neuroimaging phenotypes: A meta-analytical perspective on twin imaging studies

Because brain structure and function are affected in neurological and psychiatric disorders, it is important to disentangle the sources of variation in these phenotypes. Over the past 15 years, twin studies have found evidence for both genetic and environmental influences on neuroimaging phenotypes, but considerable variation across studies makes it difficult to draw clear conclusions about the relative magnitude of these influences. Here we performed the first meta-analysis of structural MRI data from 48 studies on >1,250 twin pairs, and diffusion tensor imaging data from 10 studies on 444 twin pairs. The proportion of total variance accounted for by genes (A), shared environment (C), and unshared environment (E), was calculated by averaging A, C, and E estimates across studies from independent twin cohorts and weighting by sample size. The results indicated that additive genetic estimates were significantly different from zero for all metaanalyzed phenotypes, with the exception of fractional anisotropy (FA) of the callosal splenium, and cortical thickness (CT) of the uncus, left parahippocampal gyrus, and insula. For many phenotypes there was also a significant influence of C. We now have good estimates of heritability for many regional and lobar CT measures, in addition to the global volumes. Confidence intervals are wide and number of individuals small for many of the other phenotypes. In conclusion, while our meta-analysis shows that imaging measures are strongly influenced by genes, and that novel phenotypes such as CT measures, FA measures, and brain activation measures look especially promising, replication across independent samples and demographic groups is necessary.

Education critical to going beyond business as usual

As government and industry grapple with 21st century challenges, building the capacity to look at complex problems through fresh eyes is critical.

Manipulating the data: Teaching and NAPLAN in the control society

High-stakes testing is changing what it means to be a ‘good teacher’ in the contemporary school. This paper uses Deleuze and Guattari's ideas on the control society and dividuation in the context of National Assessment Program Literacy and Numeracy (NAPLAN) testing in Australia to suggest that the database generates new understandings of the ‘good teacher’. Media reports are used to look at how teachers are responding to the high-stakes database through manipulating the data. This article argues that manipulating the data is a regrettable, but logical, response to manifestations of teaching where only the data counts.

Doing something about it: Representations of NAPLAN in the public domain

Since 2008 all Australian school students have sat standardised tests in Reading, Writing, Language Conventions (Spelling, Grammar and Punctuation) and Numeracy in years 3,5,7 and 9. NAPLAN tests report individual students' attainment of skills against a set of standards. Individual student results are communicated to parents. Schools are then ranked against other schools depending upon the aggregate of their NAPLAN results. The process is explained to parents and community members as “improving the learning outcomes for all Australian students” (MCEETYA, 2009). This paper will examine NAPLAN as it is being played out in a mediated space through analysing unsolicited comment found in new media such as Twitter and online forums. NAPLAN intersects with contemporary debates about Australian education policy: the roles schools should play in improving national productivity, the relationship between state and federal government interest in education, the role and expectations of the teacher, what curriculum and pedagogy should be and look like and how limited financial resources can best be spread across education sectors and systems. These are not new considerations, however, what has changed is that education policy seems to have become even more of a political issue than it has before. This paper uses Ball's 'toolkit' approach to education policy analysis to suggest that there are multiple 'effects' of NAPLAN culminating in a series of disconnected conversations between various stakeholders.

Race, the senses, and the materials of writing practices

The paper is a critical argument foregrounding race, the senses, and the materials of literacy practices. The author argues that counter-colonial literacies in the contemporary times require openly acknowledgement of the influences of white imperialism and racism in dominant schooling practices. The first concern is narrow conceptions of literacy and schooling that follow a white racial script, and which function as a form of historical reproduction, control, and privilege. The second is the need to acknowledge the need to rediscover the sensory nature of literacy practices that is intrinsic to many cultures, and which is transformed in human interactions with new digital forms of textual production. The final argument is the need to attend to the materiality of literacy practices, including the meanings connected to the material ecology. This principle is particularly relevant to Indigenous culture and experience, but likewise, to all digital environments where the materials of literacy practices are continually shifting.

Atmospheres : Aesthetics of emotional spaces[Review]

More problematic than his avoidance of recent geographic scholarship is his treatment of indigenous, ethnographic and postcolonial perspectives on island life. Not only is much of this scholarship absent, the bits that are there are mostly derided. He slams Kamau Braithwaite and his concept of ‘tidalectics’ as ‘unpackable’ (p. 20) and also claims that Greg Dening’s approach to islands as having ‘permeable cultural boundaries’ has ‘intellectual costs’ (p. 23). In a section of the book on ‘Naming and Sovereignty’, instead of an in-depth examination of the processes of decoding and recoding that goes on in indigenous island landscapes under colonialism (as could be discussed at length if Shell chose to examine Aotearoa, Hawaii, or hundreds of other places) we are instead presented a vignette about his childhood street fights with other kids over the naming of a hometown island in Canada, as well as ruminations about what Herman Melville and Ellen Semple thought of islands in the nineteenth century. In short, if you want to know what dead Caucasians like Shakespeare, Melville, Kant, Mackinder, More, and ancient Athenians thought about islands, then this book is a good resource. If, however, you are looking for information about what islands are like today – and what they mean to the people who live on and interact with them – then you will have to look elsewhere.