Malnutrition and falls risk in community-dwelling older adults

Background and Aims: Falls and fall-related injuries result in reduced functioning, loss of independence, premature nursing home admissions and mortality. Malnutrition is associated with falls in the acute setting, but little is known about malnutrition and falls risk in the community. The aim of this study was to assess the association between malnutrition risk, falls risk and falls over a one-year period in community-dwelling older adults. Methods: Two hundred and fifty four subjects >65 years of age were recruited to participate in a study in order to identify risk factors for falls. Malnutrition risk was determined using the Mini Nutritional Assessment–Short Form. Results: 28.6% had experienced a fall and according to the Mini Nutritional Assessment-Short Form 3.9% (n=10) of subjects were at risk of malnutrition. There were no associations between malnutrition risk, the risk of falls, nor actual falls in healthy older adults in the community setting. Conclusions: There was a low prevalence of malnutrition risk in this sample of community-dwelling older adults and no association between nutritional risk and falls. Screening as part of a falls prevention program should focus on the risk of developing malnutrition as this is associated with falls.

National Institute for Clinical Studies Report for Phase 1, Evidence Uptake Network : Best Practice Community Care for Clients with Chronic Venous Leg Ulcers

Chronic leg ulcers cause significant pain, cost, decreased quality of life and morbidity for a considerable segment of the older population (Graham et al., 2003a). At any given time the prevalence of patients with open leg ulcers receiving treatment is between 0.11% - 0.18% (Briggs & Closs 2003). Chronic leg ulcers occur in approximately 1 - 2% of the over 60 population in the US, UK, Europe and Australia (Baker & Stacey 1994; Johnson 1995; Lees & Lambert 1992; Margolis et al. 2002). Considerable research has been undertaken to determine the best treatment practices that will aid in the management and the healing of these ulcers, and practical and effective strategies and techniques for healing venous leg ulcers have been trialled to demonstrate their beneficial effects (Nelson et al. 2004; Cullum et al. 2001)...

Barriers and facilitators to diabetes self-management: Perspectives of older community dwellers and health professionals in China

Little is known about self-management among people with Type 2 diabetes living in mainland China. Understanding the experiences of this target population is needed to provide socioculturally relevant education to effectively promote self-management. The aim of this study was to explore perceived barriers and facilitators to diabetes self-management from both older community dwellers and health professionals in China. Four focus groups, two for older people with diabetes and two for health professionals, were conducted. All participants were purposively sampled from two communities in Shanghai, China. Six barriers were identified: overdependence on but dislike of western medicine, family role expectations, cuisine culture, lack of trustworthy information sources, deficits in communication between clients and health professionals, and restriction of reimbursement regulations. Facilitators included family and peer support, good relationships with health professionals, simple and practical instruction and a favourable community environment. The findings provide valuable information for diabetes self-management intervention development in China, and have implications for programmes tailored to populations in similar sociocultural circumstance.

Submission to the Legal Affairs and Community Safety Committee - Youth Justice (Boot Camp Orders) and Other Legislation Amendment Bill 2012

This submission addresses the Youth Justice (Boot Camp Orders) and Other Legislation Amendment Bill 2012 which has as its objectives (1) the introduction of a Boot Camp Order as an option instead of detention for young offenders and (2) the removal of the option of court referred youth justice conferencing for young offenders. As members of the QUT Faculty of Law Centre for Crime and Justice we welcome the invitation to participate in the discussion of these issues which are critically important to the Queensland community at large but especially to our young people.

Looking Yonder : Longitudinal Research and Evaluation of the Yonder Participative Arts-based Learning Model Report 2010-2012

Since 2007, KITE Arts Education Program @ QPAC has been engaged in a series of arts and drama-based experiences for students in selected primary schools on the edges of Brisbane and in regional Queensland. The in-school workshop experiences of the program have culminated in a performance by the children for their school community, parents and carers at the Queensland Performing Arts Centre or a regional cultural venue. In conducting an analysis of the Yonder project, the researcher aimed to provide evidence of outcomes brought about through participation by schools, school staff, students and their communities in the Yonder project. To develop longitudinal data project initiators, participants were interviewed at six-monthly intervals to establish patterns of engagement and participation. The report analyses arts-based workshops conducted by the teacher artist in edge-city Brisbane and a regional centre; interviews with teachers and school administrators from the participating schools; interviews with teacher artist and professional artists; interviews with community partners; teacher professional development workshops; community-based workshops; performance outcomes that were the culminating events of the workshop program; student work samples and student reflections on the program. This document covers data and project outputs from February 2010 to July 2012. There have been five iterations of the Yonder project since its commencement in mid-2009 — three in regional Queensland (February–April 2010; February–May 2011; February–May 2012) and two in edge-city1 Brisbane (July–September 2010; August–October 2011). This report is a result of a research partnership between Queensland Performing Arts Centre and Queensland University of Technology (QUT) Creative Industries Faculty(Drama).

Creating Queensland, creative communities partnership - major Brisbane festival & Australia Council for the Arts

In March 2010, Brisbane Festival commissioned a Research Team, led by Dr Bree Hadley and Dr Sandra Gattenhof, Creative Industries Faculty, Queensland University of Technology, to conduct an evaluation of the Creating Queensland program, a new Creative Communities partnership between Brisbane Festival and the Australia Council for the Arts. This Final Report reviews and reports on the effectiveness of the program gathered during three phases throughout 2010: Phase 1, in which the research team analysed Brisbane Festival’s pre-existing data on the Creating Queensland events in 2009; Phase 2, in which the research team designed a new suite of instruments to gather data from producers, producing partners, artists and attendees involved in the Creating Queensland events in 2010; and Phase 3, in which the research team used content analysis of the narratives emerging in the data to establish how Brisbane Festival has adopted processes, activities or engagement protocols to operate as catalysts that produce experiences with specific impacts on individuals and communities. The Final Report finds that the Creating Queensland events concentrate on developing specific experiences for those involved – usually associated with storytelling, showcasing, and the valorisation or re-valorisation of neglected or forgotten cultural forms – in order to give communities a voice. It finds that the events prioritise accessibility – usually associated with allowing specific local communities or local artists to present material that is meaningful to them – and inclusivity – usually associated with using connections with producing partners (such as the Multicultural Development Association) to bring more and more people into the program. It finds that the events have a capacity-building effect, which allows local communities to increase their capacity to launch their own ideas, initiatives or events, allows individuals to increase their employability, or allows communities and individuals to increase their visibility within mainstream cultural practices and infrastructure. The Final Report further finds that Brisbane Festival has, throughout its years of commitment to community programming, developed specific techniques to enable events in the Creating Queensland program to have these effects, that these can be tracked, and, as a result, deployed or redeployed both by Brisbane Festival and other community arts organisations in the development of effective community arts programs. The data demonstrates that Creating Queensland is, by and large, having the desired effect on communities – people are actually participating, presenting work, and increasing their personal, professional and social skills in various ways, and this is valued by all stakeholders. The data also demonstrates that, as would be expected with any community arts program – particularly programs of this size and complexity – there are areas in which Creating Queensland is functioning exceptionally well and areas in which continuous improvement processes should be continued. Areas of excellence relate to Brisbane Festival’s longstanding commitment to community arts, and active community participation in the arts, as well as its ability to create well-known and loved programs that use effective techniques to have a positive impact on communities. Areas for improvement relate to Brisbane Festival’s potential to benefit from the following: clarifying relationships between community participants and professionals; increasing mentoring relationships between these groups; consolidating the discourses it uses to describe event aims across strategic, production, and publicity documents across the years; and re-considering the number of small events inside the larger Creating Queensland program.

Community development with survivors of torture and trauma : an evaluation framework

Despite an increase in community development initiatives in refugee contexts, there is a lack of evaluation frameworks to assess the effectiveness of interventions in the recovery of refugee communities. In response to this gap, the Forum of Australian Services for Survivors of Torture and Trauma has developed an evaluation framework in consultation with refugee client groups and agencies' staff members. This paper contextualizes the goals, principles and strategies of services implementing community development initiatives with torture and trauma survivors and describes the process of developing the framework within a participatory action approach. Both outcome evaluation and process evaluation are discussed, and examples of the framework are presented. Community development agencies and professionals working with survivors of torture and trauma can play a significant role by fostering community empowerment through evaluation.

Community-based asylum seekers’ use of primary health care services in Melbourne

Objective: To investigate primary health care service utilisation and health presentations among asylum seekers living in Melbourne. Design and setting: Retrospective audit of files of people who attended three Melbourne asylum-seeker health clinics between 1 July 2005 and 30 June 2006. Main outcome measures: Rates of reasons for the encounter, diagnostic tests or investigations required, treatments prescribed and referrals. Results: Data were collected from 998 consultations corresponding to 341 people. Eighty-eight per cent of visits involved people with no Medicare access, owing to their visa status. The most common reasons for the encounter were general and unspecified symptoms or problems (rate, 59.9 per 100 encounters; 95% CI, 55–65), followed by musculoskeletal conditions (27.1; 95% CI, 24–30), and psychological problems (26.5; 95% CI, 23–30). The rate of referrals was 18.3 per 100 encounters (95% CI, 16–21). Conclusions: The three clinics providing services to asylum seekers in Melbourne are delivering care to a considerable number of people with complex health needs. A substantial number of asylum seekers present to clinics with psychological and social problems. Most cannot access government-subsidised health care. This must be addressed urgently by policy change at the federal and state and territory levels.

The value of community wellbeing for locality based practice

This presentation put forward six propositions regarding the value and character of community wellbeing, in particular the economic contribution of social and community programs and initiatives. The six propositions are: 1. Community wellbeing is a useful umbrella concept 2. Everyone benefits from public programs 3. There is an economic as well as social cost of not responding well 4. Local government is key in fostering community wellbeing 5. Good practice involves bringing together a number of perspectives and levers, including social and cultural initiatives 6. Engaging with the community around wellbeing offers an opportunity to enhance the political process

Evaluation of implementation of a healthy food and drink supply strategy throughout the whole school environment in Queensland state schools, Australia

BACKGROUND/OBJECTIVES: This paper reports on the evaluation of the Smart Choices healthy food and drink supply strategy for Queensland schools (Smart Choices) implementation across the whole school environment in state government primary and secondary schools in Queensland, Australia. SUBJECTS/METHODS: Three concurrent surveys using different methods for each group of stakeholders that targeted all 1275 school Principals, all 1258 Parent and Citizens’ Associations (P&Cs) and a random sample of 526 tuckshop convenors throughout Queensland. Nine hundred and seventy-three Principals, 598 P&Cs and 513 tuckshop convenors participated with response rates of 78%, 48% and 98%, respectively. RESULTS: Nearly all Principals (97%), P&Cs (99%) and tuckshop convenors (97%) reported that their school tuckshop had implemented Smart Choices. The majority of Principals and P&Cs reported implementation, respectively, in: school breakfast programs (98 and 92%); vending machine stock (94 and 83%); vending machine advertising (85 and 84%); school events (87 and 88%); school sporting events (81 and 80%); sponsorship and advertising (93 and 84%); fundraising events (80 and 84%); and sporting clubs (73 and 75%). Implementation in curriculum activities, classroom rewards and class parties was reported, respectively, by 97%, 86% and 75% of Principals. Respondents also reported very high levels of understanding of Smart Choices and engagement of the school community. CONCLUSIONS: The results demonstrated that food supply interventions to promote nutrition across all domains of the school environment can be implemented successfully.

Asylum seekers living in the community on Bridging Visa E : community sector’s response to detrimental policies

In 1997, the Australian government introduced regulations restricting work rights, income and Medicare access to asylum seekers living in the community on Bridging Visa E (BVE). These visa conditions have resulted in unacceptable hardship for asylum seekers. In response, a variety of community-based agencies have been established across Australia. This study documents and collates the experiences of some of these agencies working in Victoria. These organizations maintain a high degree of inter-agency communication and liaison, have an extensive community support network by way of volunteer work and financial assistance from philanthropic organizations and the public, and have developed successful alternative models of care for asylum seekers. However, many of the agencies have been unprepared and under-resourced for the specific legal, cultural, and health concerns common to asylum seekers on BVE. A discussion of the issues faced by the community sector in the current asylum seeker/refugee political context is presented

Pedagogy and paradox : teaching interpretation in a religious community

A qualitative, discourse analytic study of literate practices in a small religious community in a northern Australian city. The chapter documents how this community constructs religious reading and writing, affiliated ideologies and theologies, and how readers/hearers/learners are positions vis a vis the authority of sacred text.

Media education, collaboration and industry : a case study of what a group of year 10 and 11 students value in a community of practice

This case study incorporated an analysis of a group of young people as media producers and placed young people’s perspectives of their media education learning at the core of the analysis. Communities of practice social learning theory provided an effective conceptual framework for investigating the nature of the participants’ involvement in a secondary school and creative industry partnership. The analysis of the data in this study indicated that the participants valued their learning by imagining, actively participating and belonging to a media education community of practice. By enabling young people to work directly with creative industries this school and industry partnership provided students with what they saw as valuable first-hand experience of professional expertise, that contributed to students’ understanding of their own and others’ identities.

Negotiating : experiences of community nurses when contracting with clients

A community nurse is required to have excellent interpersonal, teaching, collaborative and clinical skills in order to develop effective individualised client care contracts. Using a descriptive qualitative design data was collected from two focus groups of fourteen community nurses to explore the issues surrounding negotiating and contracting client care contracts from the perspective of community nurses. Thematic analysis revealed three themes: ‘assessment of needs’, ‘education towards enablement’, and ‘negotiation’. ‘Assessment of needs’ identified that community nurses assess both the client’s requirements for health care as well as the ability of the nurse to provide that care. ‘Education towards enablement’ described that education of the client is a common strategy used by community nurses to establish realistic goals of health care as part of developing an ongoing care plan. The final theme, ‘negotiation’, involved an informed agreement between the client and the community nurse which forms the origin of the care contract that will direct the partnership between the client and the nurse. Of importance for community nurses is that development of successful person-centred care contracts requires skillful negotiation of care that strikes the balance between the needs of the client and the ability of the nurse to meet those needs.