Moving from theory to praxis on the fly: Introducing a salutogenic method to expedite mental health care provision in disaster situations

Not a lot is known about most mental illness. Its triggers can rarely be established and nor can its aetiological dynamics, so it is hardly surprising that the accepted treatments for most mental illnesses are really strategies to manage the most overt symptoms. But with such a dearth of knowledge, how can worthy decisions be made about psychiatric interventions, especially given time and budgetary restrictions? This paper introduces a method, extrapolated from Salutogenics; the psycho-social theory of health introduced by Antonovsky in 1987. This method takes a normative stance (that psychiatric health care is for the betterment of psychiatric patients), and applies it to any context where there is a dearth of workable knowledge. In lieu of guiding evidence, the method identifies reasonable alternatives on the fly, enabling rational decisions to be made quickly with limited resources.

Foreword

A critical discussion of deficit models in cross-cultural education and educational research on language and literacy development and acquisition.

Democratic and participatory citizenship: Youth action for sustainability in Australia

Purpose – The purpose of this paper is to provide a critical analysis of recent examples of action competence among young people engaged in democratic participatory action in sustainability programs in Australia. It explores examples of priorities identified for citizen action, the forms this action takes and the ways that democratic participation can achieve positive outcomes for future sustainability. It suggests multiple ways for developing action competence that provides further opportunities for authentic and engaging citizen action for youth connected to school- and community-based learning, in new and powerful ways. Design/methodology/approach – This conceptual paper examines international literature on the theory of “action competence,” its significance for education for sustainability (EfS) and the ways it can inform education for young people’s democratic participatory citizenship and civic engagement. It analyses examples of the development of action competency among young people in Australia, including the problems and priorities identified for citizen action, the forms this action takes and how it can achieve positive outcomes for sustainability. Following this analysis, the paper suggests multiple ways for developing action competence in EfS in schools and communities in new and powerful ways. Findings – Developing EfS to increase democratic and participatory action among young citizens is now widely regarded as an urgent education priority. There are growing exemplars of school and community organizations’ involvement in developing EfS learning and teaching to increase participatory citizenship. Young people are being empowered to develop a greater sense of agency through involvement in programs that develop action competence with a focus on sustainability in and out of school. New forms of participation include student action teams and peer collaboration among youth who are marshaling social media and direction action to achieve change. Originality/value – It contributes to the literature on multiple ways for developing action competence in EfS.

Parkinson's disease, nutrition, and surgery in context of critical care

Parkinson’s disease is a common neurodegenerative disorder with a higher risk of hospitalization than the general population. Therefore, there is a high likelihood of encountering a person with Parkinson’s disease in acute or critical care. Most people with Parkinson’s disease are over the age of 60 years and are likely to have other concurrent medical conditions. Parkinson’s disease is more likely to be the secondary diagnosis during hospital admission. The primary diagnosis may be due to other medical conditions or as a result of complications from Parkinson’s disease symptoms. Symptoms include motor symptoms, such as slowness of movement and tremor, and non-motor symptoms, such as depression, dysphagia, and constipation. There is a large degree of variation in the presence and degree of symptoms as well as in the rate of progression. There is a range of medications that can be used to manage the motor or non-motor symptoms, and side effects can occur. Improper administration of medications can result in deterioration of the patient’s condition and potentially a life-threatening condition called neuroleptic malignant-like syndrome. Nutrients and delayed gastric emptying may also interfere with intestinal absorption of levodopa, the primary medication used for motor symptom management. Rates of protein-energy malnutrition can be up to 15 % in people with Parkinson’s disease in the community, and this is likely to be higher in the acute or critical care setting. Nutrition-related care in this setting should utilize the Nutrition Care Process and take into account each individual’s Parkinson’s disease motor and non-motor symptoms, the severity of disease, limitations due to the disease, medical management regimen, and nutritional status when planning nutrition interventions. Special considerations may need to be taken into account in relation to meal and medication times and the administration of enteral feeding. Nutrition screening, assessment, and monitoring should occur during admission to minimize the effects of Parkinson's disease symptoms and to optimise nutrition-related outcomes.

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.

Forward: On Chineseness

A critical commentary on issues of Chinese identity, habitus and language.

Perubahan bahasa dalam perspektif Pre neogrammarian dan Neogrammarian dan Pengajaran bahasa dalam konteks EFL (Pre-Neogrammarian and Neogrammarians’ language change and English language pedagogy in EFL contexts)

This article describes different perspectives in response to language change, and aligns the perspectives of language change to English language pedagogy in non-English speaking contexts. The Pre-Neogrammarian and Neo-grammarian linguists that believe the change leads to respectively language decay or language existence will be outlined. This article suggests that the theories derived from both perspectives can be applied to any language. Once there is cultural contact between languages, the dominant language tends to suppress the non-dominant language. Hence, besides focusing on changes that happen in English and the effects of the changes into this language, this article also considers that other language—in this case EFL teachers’ “local language”—experiences an adverse change as the result of the speakers’ interaction with English. Then, this article also describes how the changes might lead to EFL teachers’ adaptation in their practice and cause teachers’ dilemmas.

Notes on the future of critical discourse studies

In How to Do Things with Words, Austin (1975) described marriages, sentencings and ship launchings as prototypes of performative utterance. What’s the appropriate speech act for launching an academic journal? First editions of journals tend to take a field as formed a priori, as having “come of age”, and state good intents to capture its best or most innovative work.

Engaging a multiple-track approach to building capacity for 21st Century engineering, opportunities and challenges for rapid curriculum renewal

‘Complexity’ is a term that is increasingly prevalent in conversations about building capacity for 21st Century professional engineers. Society is grappling with the urgent and challenging reality of accommodating seven billion people, meeting needs and innovating lifestyle improvements in ways that do not destroy atmospheric, biological and oceanic systems critical to life. Over the last two decades in particular, engineering educators have been active in attempting to build capacity amongst professionals to deliver ‘sustainable development’ in this rapidly changing global context. However curriculum literature clearly points to a lack of significant progress, with efforts best described as ad hoc and highly varied. Given the limited timeframes for action to curb environmental degradation proposed by scientists and intergovernmental agencies, the authors of this paper propose it is imperative that curriculum renewal towards education for sustainable development proceeds rapidly, systemically, and in a transformational manner. Within this context, the paper discusses the need to consider a multiple track approach to building capacity for 21st Century engineering, including priorities and timeframes for undergraduate and postgraduate curriculum renewal. The paper begins with a contextual discussion of the term complexity and how it relates to life in the 21st Century. The authors then present a whole of system approach for planning and implementing rapid curriculum renewal that addresses the critical roles of several generations of engineering professionals over the next three decades. The paper concludes with observations regarding engaging with this approach in the context of emerging accreditation requirements and existing curriculum renewal frameworks.

Re-engineering higher education for energy efficiency solutions

Emerging 21st century challenges require higher education institutions (HEIs) to play a key role in developing graduates and professionals, particularly in engineering and design, who can forge sustainable solutions. The trouble is there’s currently a significant lag in the preparedness of HEIs to provide the stream of professionals needed. Addressing energy efficiency competencies is one critical area.

A summary of the 'Engineering Education for Sustainable Development:Toolkit of Information & Teaching Material'

This paper reflects on the critical need for an urgent transformation of higher education curriculum globally, to equip society with professionals who can address our 21st Century sustainable living challenges. Specifically it discusses a toolkit called the ‘Engineering Sustainable Solutions Program’, which is a freely available, rigorously reviewed and robust content resource for higher education institutions to access content on innovations and opportunities in the process of evolving the curriculum...

A taste of best practice in engineering sustainable solutions

This paper asks the question to what scale and speed does society need to reduce its ecological footprint and improve resource productivity to prevent further overshoot and return within the ecological limits of the earth’s ecological life support systems? How fast do these changes need to be achieved? The paper shows that now a large range of studies find that engineering sustainable solutions need to be roughly an order or magnitude resource productivity improvement (sometimes called a Factor of 10, or a 90% reduction) by 2050 to achieve real and lasting ecological sustainability. This marks a significant challenge for engineers – indeed all designers and architects, where best practice in engineering sustainable solutions will need to achieve large resource productivity targets. The paper brings together examples of best practice in achieving these large targets from around the world. The paper also highlights key resources and texts for engineers who wish to learn how to do it. But engineers need to be realistic and patient. Significant barriers exist to achieving Factor 4-10 such as the fact that infrastructure and technology rollover and replacement is often slow. This slow rollover of the built environment and technology is the context within which most engineers work, making the goal of achieving Factor 10 all the more challenging. However, the paper demonstrates that by using best practice in engineering sustainable solutions and by addressing the necessary market, information and institutional failures it is possible to achieve Factor 10 over the next 50 years. This paper draws on recent publications by The Natural Edge Project (TNEP) and partners, including Hargroves, K. Smith, M. (Eds) (2005) The Natural Advantage of Nations: Business Opportunities, Innovation and Governance for the 21st Century, and the TNEP Engineering Sustainable Solutions Program - Critical Literacies for Engineers Portfolio. Both projects have the significant support of Engineers Australia. its College of Environmental Engineers and the Society of Sustainability and Environmental Engineering.

Making the profitable transition towards sustainable business practice

The last three decades have been difficult for companies and industry. In an increasingly competitive international business climate with shifting national environmental regulations, higher standards are being demanded by the consumer and community groups, not-to-mention the escalating cost of primary resources such as water, steel and minerals. The cause of these pressures is the traditional notion held by business executives and engineers that there is an inherent trade off between eco-efficiency and improving the economic bottom line. However there is significant evidence and examples of best practice to show that there is in fact no trade-off between the environment and the economy if sustainable development through continual improvement is adopted. It is highly possible therefore for companies to make a profitable transition towards sustainable business practice, where along the transition significant business opportunities can be taken advantage of. Companies are by their very nature dynamic, influential and highly capable of adapting to change. Making an organisational transformation to a sustainable business is not outside the capacity of the typical company, who know much of what is needed already to change their activities to satisfy current market demands while achieving competitiveness. However in order to make the transition towards sustainable business practice companies require some key mechanisms such as accurate information on methodologies and opportunities, understanding of the financial and non-financial incentives, permission from stakeholders and shareholders, understanding of the emerging market opportunities, a critical mass of leaders in their sector and demonstrated case studies, and awarding appropriate risk-taking activities undertaken by engineers and CEOs. Satisfying these requirements will adopt an innovative culture within the company that strives for continual improvement and successfully transforms itself to achieve competitiveness in the 21st Century. This paper will summarise the experiences of The Natural Edge Project (TNEP) and its partners in assisting organisations to make a profitable transition towards sustainable business practice through several initiatives. The Natural Advantage of Nations publication provides the critical information required by business leaders and engineers to set the context of sustainable business practice. The Profiting in a Carbon Constrained World report, developed with Natural Capitalism Inc led by Hunter Lovins, summarises the opportunities available to companies to take advantage of the carbon trading market mechanisms such as the Chicago Climate Exchange and European Climate Exchange. The Sustainability Helix then guides the company through the transition by identifying the key tools and methodologies required by companies to reduce environmental loading while dramatically improving resource productivity and achieving competitiveness. Finally, the Engineering Sustainable Solutions Program delivers the key engineering information required by companies and university departments to deliver sustainable engineering solutions. The initiatives are of varying complexity and level of application, however all are designed to provide key staff the critical information required to make a profitable transition towards sustainable business practice. It is then their responsibility to apply and teach their knowledge to the rest of the organisation.

‘True Blood’ the critical care story: An audit of blood sampling practice across three adult, paediatric and neonatal intensive care settings

Background Anaemia is common in critically ill patients, and has a significant negative impact on patients' recovery. Blood conservation strategies have been developed to reduce the incidence of iatrogenic anaemic caused by sampling for diagnostic testing. Objectives Describe practice and local guidelines in adult, paediatric and neonatal Australian intensive care units (ICUs) regarding blood sampling and conservation strategies. Methods Cross-sectional descriptive study, conducted July 2013 over one week in single adult, paediatric and neonatal ICUs in Brisbane. Data were collected on diagnostic blood samples obtained during the study period, including demographic and acuity data of patients. Institutional blood conservation practice and guidelines were compared against seven evidence-based recommendations. Results A total of 940 blood sampling episodes from 96 patients were examined across three sites. Arterial blood gas was the predominant reason for blood sampling in each unit, accounting for 82% of adult, 80% of paediatric and 47% of neonatal samples taken (p <. 0.001). Adult patients had significantly more median [IQR] samples per day in comparison to paediatrics and neonates (adults 5.0 [2.4]; paediatrics 2.3 [2.9]; neonatal 0.7 [2.7]), which significantly increased median [IQR] blood sampling costs per day (adults AUD$101.11 [54.71]; paediatrics AUD$41.55 [56.74]; neonatal AUD$8.13 [14.95]; p <. 0.001). The total volume of samples per day (median [IQR]) was also highest in adults (adults 22.3. mL [16.8]; paediatrics 5.0. mL [1.0]; neonates 0.16. mL [0.4]). There was little information about blood conservation strategies in the local clinical practice guidelines, with the adult and neonatal sites including none of the seven recommendations. Conclusions There was significant variation in blood sampling practice and conservation strategies between critical care settings. This has implications not only for anaemia but also infection control and healthcare costs.