Building community capacity for end of life : an investigation of community capacity and its implications for health-promoting palliative care in the Australian Capital Territory

This study identified and examined community-based activities around death, dying and end-of-life care which might reflect a health-promoting palliative care (HPPC) philosophy. This approach is argued to restore community ownership of, and agency in, dying and death through the building of community capacity. However, the enactment of the HPPC approach has not been extensively examined in Australia. Current understandings of community capacity-building relating to end of life are orientated toward service provision. A qualitative interpretive approach was used to engage with local community groups in the Australian Capital Territory with an interest in death, dying and end-of-life care. Data were collected from ten in-depth, semi-structured interviews and thematically analysed. The themes of Practical Support, Respect and Responsiveness and Connection and Empowerment were identified, reflecting community activities initiated in response to the experience of life-limiting illness. Building community capacity offers to restore community agency in end-of-life concerns, while potentially enhancing health service provision through collaborative partnerships. This study indicates an existing community capacity, demonstrated by activities that promote socialisation, peer support and normalisation of death and dying. However, as these activities occur primarily in response to illness, proactive and preparatory interventions in HPPC are a priority.

Stigmatization of failed entrepreneurs : prevalence and solutions

This paper investigates why entrepreneurs experience stigma after firm failure and what can be done to reduce it. We use attribution theory as an overarching theoretical framework and hypothesize that entrepreneurs are held more accountable than employees for their unemployment after firm failure irrespective of the circumstances causing the failure. To test this hypothesis we conduct a between group, 2x2 full factorial experiment where the cause of the failure is manipulated. We find that entrepreneurs are held more accountable for firm failure irrespective of the circumstances causing the failure and that respondents who view failure as an inherent risk of firm ownership are less likely to stigmatize failed entrepreneurs.

No child’s play: Recognising the agency of former child soldiers in peace building processes

Engaging with the emerging discourse on children that recognises childhood as culturally specific and that children actively engage with their environment, this paper questions the dominant discourse’s view of children as passive recipients of socialisation. This paper argues that the discourse on children’s agency is a more useful framework for understanding the experiences of former child soldiers and that engaging meaningfully with this discourse will both improve life outcomes and reduce the risk of ongoing instability. This argument is made by an examination of the two discourses; examining their development and arguing for the usefulness of the agency discourse. This provides for an examination of children’s agency in education and skills training programs and of their political involvement (or marginalisation) in three conflicts: Colombia, Sierra Leone and Uganda. Recognising children as agents and engaging with how they navigate their lived experiences after involvement in conflict testifies to children’s resilience and their desire for change. Challenging the dominant discourse through the agency discourse allows for the acknowledgement of former child soldiers as both social and political agents in their own right and of their potential for contributing to stable and lasting peace.

Flight-training effect on the cervical muscle isometric strength of trainee pilots

External stimulus/loading initiates adaptations within skeletal muscle. It has been previously found that the cervical area has the highest loading while performing flying maneuvers under +Gz. The first purpose of this study was to examine the neck muscle response to the physical environment associated with flight training, incorporating limited exposure to +Gz force, in a Pilatus PC-9 aircraft. The second purpose was to examine the short-term range of movement (ROM) response to flight training. Isometric cervical muscle strength and ROM was monitored in 9 RAAF pilots completing an 8-mo flight-training course at Pearce Airbase in Western Australia, and in 10 controls matched for gender, age, height, and weight. Isometric cervical muscle strength and ROM were measured at baseline and at 8 mo using the multi-cervical rehabilitation unit (Hanoun Medical, Downsview, Ontario, Canada). Results indicated that an increase in pilot neck strength was limited to flexion while in a neutral position. No strength changes were recorded in any other site in the pilots or for the controls. These findings suggest that short-term exposure to the physical environment associated with flight training had a limited significant effect on increasing isometric cervical muscle strength. No significant changes were observed in pilot ROM, indicating that short-term exposure to flight does not effect ROM.

Is being #instagay different from an #lgbttakeover? A cross-platform investigation of sexual and gender identity performances

This paper introduces research in progress that examines how queer women perform sexual identity across social media platforms. Applying a lens of queer theory and Actor Network Theory, it discusses women’s embodied self-representations as taking on forms that both conform to and elaborate upon the selfie genre of digital representation. Acknowledging similarities and differences across platforms, specifically between Instagram and Vine, a novel walkthrough method is introduced to identify platform characteristics that shape identity performances. This method provides insights into the role of platforms in identity performances, which can be combined with analysis of user-generated content and interviews to better understand digital media’s constraints and affordances for queer representation.

Becoming bilingual: Children’s insights about making friends in bilingual settings

The majority of the world speaks more than one language yet the impact of learning a second language has rarely been studied from a child’s perspective. This paper describes monolingual children’s insights into becoming bilingual at four time points: two months before moving to another country (while living in Australia), as well as one, six, and twelve months after moving to Germany. The participants were two monolingual English-speaking siblings (a male aged 7- to 8-years and a female aged 9- to 10-years) who subsequently learned to speak German. At each of the four time points, interviews were undertaken with each child using child-friendly drawing and questionnaire techniques. Three themes were identified: (1) the children’s awareness of language competence; (2) inclusion factors, and; (3) exclusion factors that influenced friendship formation. The impact of language ability on making friends was a dominant theme that arose across the four time points and was triangulated across data collection methods. The children made friends with others who had similar language competence in German, even though they were younger, and did not share the same first language. Age-matched peers who were more competent in German were less likely to be described as friends. Across all three themes, the playground was highlighted by both children as the key site where becoming bilingual most strongly impacted initiation and negotiation of friendships. Becoming bilingual impacted the children’s friendship formation and socialization opportunities with more competent language users.

The optimal frequency of aquatic physiotherapy for individuals with chronic musculoskeletal pain: a randomised controlled trial

Purpose: To establish whether there was a difference in health-related quality of life (HRQoL) in people with chronic musculoskeletal disorders (PwCMSKD) after participating in a multimodal physiotherapy program (MPP) either two or three sessions a week. Methods: Total of 114 PwCMSKD participated in this prospective randomised controlled trial. An individualised MPP, consisting of exercises for mobility, motor-control, muscle strengthening, cardiovascular training, and health education, was implemented either twice a week (G2: n = 58) or three times a week) (G3: n = 56) for 1 year. Outcomes: HRQoL physical and mental health state (PHS/MHS), Roland Morris disability Questionnaire (RMQ), Neck-Disability-Index (NDI) and Western Ontario and McMaster Universities’ Arthritis Index (WOMAC) were used to measure outcomes of MPP for people with chronic low back pain, chronic neck pain and osteoarthritis, respectively. Measures were taken at baseline, 8 weeks (8 w), 6 months (6 m), and 1 year (1 y) after starting the programme. Results: No statistically significant differences were found between the two groups (G2 and G3), except in NDI at 8 w (−3.34, (CI 95%: −6.94/0.84, p = 0.025 (scale 0–50)). All variables showed improvement reaching the following values (from baseline to 1 y) G2: PHS: 57.72 (baseline: 41.17; (improvement: 16.55%), MHS: 74.51 (baseline: 47.46, 27.05%), HRQoL 0.90 (baseline: 0.72, 18%)), HRQoL-VAS 84.29 (baseline: 58.04, 26.25%), RMQ 4.15 (baseline: 7.85, 15.42%), NDI 3.96 (baseline: 21.87, 35.82%), WOMAC 7.17 (baseline: 25.51, 19.10%). G3: PHS: 58.64 (baseline: 39.75, 18.89%), MHS: 75.50 (baseline: 45.45, (30.05%), HRQoL 0.67 (baseline: 0.88, 21%), HRQoL-VAS 86.91 (baseline: 52.64, 34.27%), RMQ 4.83 (baseline: 8.93, 17.08%), NDI 4.91 (baseline: 23.82, 37.82%), WOMAC 6.35 (baseline: 15.30, 9.32%). Conclusions: No significant differences between the two groups were found in the outcomes of a MPP except in the NDI at 8 weeks, but both groups improved in all variables during the course of 1 year under study.

Teaching children who have a diagnosis of Autism Spectrum Disorder

Best practice dictates that the Autism Spectrum Disorder (ASD) diagnostic process is informed by experienced professionals from at least two disciplines, for example psychology or speech pathology, with the diagnosis ultimately provided by a specialist medical practitioner e.g. child psychiatrist, neurologist or paediatrician. Irrespective of a child’s age, diagnosis relies upon information about their early development. Current information and observations on a child’s behaviour, communication and socialisation are considered by the specialist medical practitioner against the signs and symptoms detailed in one of several diagnostic systems. Two recently used classification systems in Australia have been the fourth edition of the Diagnostic Statistical Manual of Mental Disorders (DSM-IV) published by the American Psychiatric Association (1994) and the tenth edition of the International Classification of Disease (ICD-10), published by the World Health Organisation (2003).

Assistance arrangements and use of services among persons with multiple sclerosis and their caregivers

A large population-based survey of persons with multiple sclerosis (MS) and their caregivers was conducted in Ontario using self-completed mailed questionnaires. The objectives included describing assistance arrangements, needs, and use of and satisfaction with services, and comparing perceptions of persons with MS and their caregivers. Response rates were 83% and 72% for those with MS and caregivers, respectively. Based on 697 respondents with MS whose mean age is 48 years, 70% are female, and 75% are married. While 24% experience no mobility restrictions, the majority require some type of aid or a wheelchair for getting around. Among 345 caregivers, who have been providing care for 9 years on average, the majority are spouses. Caregivers report providing more frequent care than do persons with MS report receiving it, particularly for the following activities of daily living: eating, meal preparation, and help with personal finances. Caregivers also report assistance of longer duration per day than do care recipients with MS. Frequency and duration of assistance are positively associated with increased MS symptom severity and reduced mobility. Generally there is no rural-urban disparity in service provision, utilization or satisfaction, and although there is a wide range of service utilization, satisfaction is consistently high. Respite care is rarely used by caregivers. Use of several services is positively associated with increased severity of MS symptoms and reduced mobility. Assistance arrangements and use of services, each from the point of view of persons with MS and their caregivers, must be taken into account in efforts to prolong home care and to postpone early institutionalization of persons with MS.

General practitioner utilisation amongst urban Aboriginal and Torres Strait Islander children aged less than 5 years

Aim There are limited studies documenting the frequency and reason for attendance to primary health care services in Australian children, particularly for urban Aboriginal and Torres Strait Islander children. This study describes health service utilisation in this population in an urban setting. Methods An ongoing prospective cohort study of Aboriginal and Torres Strait Islander children aged <5 years registered with an urban Aboriginal and Torres Strait Islander primary health care centre in Brisbane, Australia. Detailed demographic, clinical, health service utilisation and risk factor data are collected by Aboriginal researchers at enrolment and monthly for a period of 12 months on each child. The incidence of health service utilisation was calculated according to the Poisson distribution. Results Between 14 February 2013 and 31 October 2014, 118 children were recruited, providing data for 535 child-months of observation. Ninety-one percent of children were Aboriginal, 4% Torres Strait Islander and 5% were both Aboriginal and Torres Strait Islander. The incidence of presentations to see a doctor for any reason was 43.9 episodes/100 child months (95%CI 38.4 – 49.9) The most common reasons for presentation were for immunisations (23%), respiratory illnesses (19%) and for Australian Government funded Indigenous child health check (16%). The primary health services used, for majority of these visits were Aboriginal and Torres Strait Islander specific medical services (61%). Conclusions Within a cultural-specific service for an urban Aboriginal and Torres Strait Islander people, there is a high frequency of childhood attendance at for primary health care services. Well-health checks and respiratory illnesses were the most common reasons. The high proportion of visits for well child services suggests a potential for opportunistic health promotion, education and early interventions across a range of child health issues.

The introduction of an Inter-professional learning unit: staff and student perspectives

Background The School of Clinical Sciences comprises a number of health disciplines including podiatry, paramedic science, pharmacy, medical imaging and radiation therapy. A new inter-professional unit was introduced in 2014, which covered key introductory learnings applicable for future health practitioners. This study examined teaching staff and student perspectives about their experience with the new unit for first year students. Methods Qualitative interviews with teaching staff (n=9) and focus group interviews with students (5 groups which ranged in size from 4-30) were conducted. Extensive notes were taken during the interviews Issues emerging from the interviews were identified and organised according to themes and subthemes. Results Four major themes were identified namely: Something new; To be or not to be that is the question; Advantages of the new unit; and Areas for improvement. Previous staff experience with inter-professional learning (IPL) had been ad-hoc, whereas the new unit brought together several disciplines in a planned and deliberate way. There was strong philosophical agreement about the value of IPL but some debate about the extent to which the unit provided IPL experience. The unit was seen as assisting students’ social and academic adjustment to university and provided opportunity for professional socialisation, exposure to macro and micro aspects of the Australian health care system and various types of communication. For podiatry students it was their first opportunity to formally meet and work with other podiatry students and moved their identity from ‘university student’ to ‘podiatry student’. Other positives included providing the opportunity for staff and students to interact at an early stage with the perceived benefit of reducing attrition. Areas for unit improvement included institutional arrangements, unit administration aspects and assessment. Conclusion The unit was seen as beneficial by staff and students however, students were more polarised in their views than staff. There was a tension between feeling apart of and learning about one's own profession and feeling apart of and learning about the roles of other health professionals in relation to patient care and the health care system.

Nuori konservatiivi : Tuure Junnila ja hänen poliittinen toimintansa vuoteen 1956

Tuure Junnila, PhD (1910-1999) was one of Finland's most renowned conservative politicians of the post-war period. Junnila is remembered primarily as a persistent opponent of Urho Kekkonen, a long-term Member of Parliament, a conspicuous opposition member and a prolific political writer. Junnila's ideologies and political views were conservative, and he is one of the most outstanding figures in the history of the National Coalition Party. Junnila also made an extensive career outside of politics, first as an economist and then as an executive of Finland's leading commercial bank Kansallis-Osake-Pankki. The Young Conservative is a partial biography written using traditional historical research methods, which examines Junnila's personal history and his activity in public life up to 1956. The study begins by investigating Junnila's background through his childhood, school years, university studies and early professional career. It also looks at Junnila's work as an economist and practical banker. Particular attention is paid to Junnila's political work, constantly focusing on the following five often overlapping areas: (1) economic policy, (2) domestic policy, (3) foreign and security policy, (4) Junnila and Urho Kekkonen, (5) Junnila, the Coalition Party and Finnish conservatism. In his economic policy, Junnila emphasised the importance of economic stability, opposed socialisation and the growth of public expenditure, defended the free market system and private entrepreneurship, and demanded tax cuts. This policy was very popular within the Coalition Party during the early 1950s, making Junnila the leading conservative economic politician of the time. In terms of domestic policy, Junnila demanded as early as the 1940s that a "third force" should be established in Finland to counterbalance the agrarian and labour parties by uniting conservative and liberal ideologies under the same roof. Foreign and security policy is the area of Junnila's political activity which is most clearly situated after the mid-1950s. However, Junnila's early speeches and writings already show a striving towards the unconditional neutrality modelled by Switzerland and Sweden and a strong emphasis on Finland's right to internal self-determination. Junnila, as did the Coalition Party as a whole, adopted a consistently critical approach towards Urho Kekkonen between 1951 and 1956, but this attitude was not as bluntly negative and all-round antagonistic as many previous studies have implied. Junnila was one of the leading Finnish conservatives of the early 1950s and in all essence his views were analogous to the general alignment of the Coalition Party at the time: conservative in ideology and general policy, and liberal in economic policy.

Heräämisten poetiikkaa : Lajeja ja intertekstejä Arvid Järnefeltin romaaneissa Isänmaa, Maaemon lapsia ja Veneh'ojalaiset

Poetics of Awakenings. Genres and Intertexts in Arvid Järnefelt s Novels Isänmaa, Maaemon lapsia and Veneh ojalaiset This doctoral dissertation focuses on Arvid Järnefelt s (1961 1932) novels Isänmaa (1893), Maaemon lapsia (1905) and Veneh ojalaiset (1909). The study applies the genre theory and concepts Alastair Fowler has introduced in his Kinds of Literature (1982). Fowler s theory of the novel is developed further and applied to Finnish realist novels. The generic analysis is supplemented by intertextual analysis, which is mainly based on the idea of specific intertextual relations as presented by Kiril Taranovsky. Generic and intertextual analyses form the basis for hermeneutic interpretation, in which attention is paid to the fact that the novels are written by the designated writer in specific historical and cultural circumstances. Instead of the author s intention , the study focuses on the realised intention , in other words the novels as they are published. Järnefelt s first novel Isänmaa is understood to be a classical Bidungsroman that depicts the socialisation of a young male protagonist. From an intertextual point of view, the novel appears to be a novel of conversion, too, due to the biblical allusions concealed in the depiction of the events. Furthermore, Isänmaa is seen to stand in an intertextual relation to Hegel s, Snellman s and Topelius s writings. Maaemon lapsia is argued to be a thesis novel, which persuades the reader to adopt a certain ideological and political stance, namely Henry George s view on the private ownership of land. The novel is modulated by the generic repertoires of fairy tale and tragedy. The mythical frame of the novel supports the thesis novel, as it gives universal validity to the particular events depicted in the novel. Maaemon lapsia also comments on the contemporary political debate on the relations between Finland and Russia by presenting the relationship as analogous to the relationship between tenant farmer and landowner. Veneh ojalaiset exhibits a wide range of genres. Comic, tragic and mythical mode is combined with, for example, family novel, romance, conversion novel and revolutionary novel. From a rhetorical viewpoint, the novel is an apology, which accuses society of generating criminality by means of unjust laws and procedures. The novel discusses the question of resistance to evil by using the themes of Faust and Job, as well as by confronting the philosophies of Epictetus and Nietzsche. The novel is a thesis novel, which disputes the possibility of violent revolution as a way to a better society and recommends passive resistance for an individual living in an unjust society. The poetics of Järnefelt s novels is regarded as the poetics of conversion, as all the novels in focus depict the protagonist s awakening to see the society in a new light, be it a patriotic vision of the reality or a conception of the unfairness of society.

Roy Kenzie Kiyooka

Roy Kenzie Kiyooka Canadian, born 1926 Roy Kiyooka was born in Moose Jaw, Saskatchewan in 1926. Throughout his career, he was known as a painter, photographer, sculptor, poet, musician, filmmaker and teacher. He studied at the Provincial Institute of Technology and Art in Calgary from 1946-49, and then at the Instituto Allende in Mexico in 1955. During the summers of 1958 - 1960 he attended the Emma Lake Workshops in Saskatchewan, where he worked closely with Barnett Newman and Clement Greenberg. In 1959 he executed his first series of abstract paintings, The Hoarfrost Series, which assume a disciplined minimal quality. In the late 1960's Kiyooka began to push beyond painting and created mixed media works, including collage, photography, film and poetry. Kiyooka’s art is born out of personal experience and through it he records his relationship to the surrounding landscape; a night in a motel, a trip to the coast, or hoarfrost on the trees. Through the unfolding of Kiyooka’s interior/exterior landscapes he shares his personal journeys with us all. The Art Gallery of Ontario's collection of Roy Kiyooka's work began with the purchase of two paintings; Barometer No. 2, in 1964 and Surya, in 1987.