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.

The use of emergency medication kits in community palliative care: An exploratory survey of views of current practice in Australian home-based palliative care services

Improving symptom management for palliative care patients has obvious benefits for patients and advantages for the clinicians, as workload demands and work-related stress can be reduced when the emergent symptoms of patients are managed in a timely manner. The use of emergency medication kits (EMKs) can provide such timely symptom relief. The purpose of this study was to conduct a survey of a local service to examine views on medication management before and after the implementation of an EMK and to conduct a nationwide prevalence survey examining the use of EMKs in Australia. Most respondents from community palliative care services indicated that EMKs were not being supplied to palliative care patients but believed such an intervention could improve patient care.

The effects of geochemical conditions on the establishment and growth of mangrove seedlings in acid sulfate soil environments

Acid sulfate soils (ASS) is a stress factor that is responsible for the failure of some mangrove restoration projects, including abandoned aquaculture ponds converted from mangrove ecosystems. Through experimental and field studies, this research provides a better understanding of the biogeochemistry of ASS disturbance and the response of mangrove seedlings (Rhizophoraceae) under high metal levels and acidic conditions. This study found that mangrove restorations under ASS disturbance can work but with lower numbers of survived seedlings. To prevent toxicity under high levels of metal, seedlings retained metals in their roots and sparingly distributed them into aerial parts with low mobility. The presence of high levels of potential acidity parameters would allow pyrite to oxidise, thus increasing metal levels and acidity, which in turn affected the survival and growth of the seedlings.

How are falls and fear of falling associated with objectively measured physical activity in a cohort of community-dwelling older men?

BACKGROUND: Falls affect approximately one third of community-dwelling older adults each year and have serious health and social consequences. Fear of falling (FOF) (lack of confidence in maintaining balance during normal activities) affects many older adults, irrespective of whether they have actually experienced falls. Both falls and fear of falls may result in restrictions of physical activity, which in turn have health consequences. To date the relation between (i) falls and (ii) fear of falling with physical activity have not been investigated using objectively measured activity data which permits examination of different intensities of activity and sedentary behaviour. METHODS: Cross-sectional study of 1680 men aged 71-92 years recruited from primary care practices who were part of an on-going population-based cohort. Men reported falls history in previous 12 months, FOF, health status and demographic characteristics. Men wore a GT3x accelerometer over the hip for 7 days. RESULTS: Among the 12% of men who had recurrent falls, daily activity levels were lower than among non-fallers; 942 (95% CI 503, 1381) fewer steps/day, 12(95% CI 2, 22) minutes less in light activity, 10(95% CI 5, 15) minutes less in moderate to vigorous PA [MVPA] and 22(95% CI 9, 35) minutes more in sedentary behaviour. 16% (n = 254) of men reported FOF, of whom 52% (n = 133) had fallen in the past year. Physical activity deficits were even greater in the men who reported that they were fearful of falling than in men who had fallen. Men who were fearful of falling took 1766(95% CI 1391, 2142) fewer steps/day than men who were not fearful, and spent 27(95% CI 18, 36) minutes less in light PA, 18(95% CI 13, 22) minutes less in MVPA, and 45(95% CI 34, 56) minutes more in sedentary behaviour. The significant differences in activity levels between (i) fallers and non-fallers and (ii) men who were fearful of falling or not fearful, were mediated by similar variables; lower exercise self-efficacy, fewer excursions from home and more mobility difficulties. CONCLUSIONS: Falls and in particular fear of falling are important barriers to older people gaining health benefits of walking and MVPA. Future studies should assess the longitudinal associations between falls and physical activity.

The long and winding road : health services for clients with chronic leg ulcers in the community

The prevalence of leg ulcers of is 0.12%–1.1% and >3,000 lower limb amputations are performed yearly in Australia due to non-healing leg or foot ulcers. Although evidence on leg ulcer management is available, a significant evidence-practice gap exists. To identify current leg ulcer management, a cross-sectional retrospective study was undertaken in Brisbane, Australia. A sample of 104 clients was recruited from a community specialist wound clinic and a tertiary hospital outpatient’s specialist wound clinic. All clients had an ulcer below their knee or on their foot for ≥4 weeks. Data were collected on ulcer care, health service usage and clinical history for the year prior to admission. On admission, participants reported having their ulcer for a median of 25 weeks (range 2-728 weeks); with 51% (53/104) reporting an ulcer duration of ≥24 weeks. Including the wound clinic, participants sought ulcer care from a median of 3 health care providers (range 2-7). General Practitioners provided ulcer care to 82% of participants. Nearly half (42%) had self-cared for their ulcer; 29% (30/104) received treatment by a community nurse. A gap was found between the community-based ulcer care experienced by this population and evidence-based guidelines in regards to assessment, management, advice, and referrals.

Spatially varying ground motion effects on seismic response of adjacent structures considering soil-structure interaction

Spatial variation of seismic ground motions is caused by incoherence effect, wave passage, and local site conditions. This study focuses on the effects of spatial variation of earthquake ground motion on the responses of adjacent reinforced concrete (RC) frame structures. The adjacent buildings are modeled considering soil-structure interaction (SSI) so that the buildings can be interacted with each other under uniform and non-uniform ground motions. Three different site classes are used to model the soil layers of SSI system. Based on fast Fourier transformation (FFT), spatially correlated non-uniform ground motions are generated compatible with known power spectrum density function (PSDF) at different locations. Numerical analyses are carried out to investigate the displacement responses and the absolute maximum base shear forces of adjacent structures subjected to spatially varying ground motions. The results are presented in terms of related parameters affecting the structural response using three different types of soil site classes. The responses of adjacent structures have changed remarkably due to spatial variation of ground motions. The effect can be significant on rock site rather than clay site.

The use of new generation geosynthetics in water treatment

The importance of clean drinking water in any community is absolutely vital if we as the consumers are to sustain a life of health and wellbeing. Suspended particles in surface waters not only provide the means to transport micro-organisms which can cause serious infections and diseases, they can also affect the performance capacity of a water treatment plant. In such situations pre-treatment ahead of the main plant is recommended. Previous research carried out using non-woven synthetic as a pre-filter materials for protecting slow sand filters from high turbidity showed that filter run times can be extended by several times and filters can be regenerated by simply removing and washing of the fabric ( Mbwette and Graham, 1987 and Mbwette, 1991). Geosynthetic materials have been extensively used for soil retention and dewatering in geotechnical applications and little research exists for the application of turbidity reduction in water treatment. With the development of new materials in geosynthetics today, it was hypothesized that the turbidity removal efficiency can be improved further by selecting appropriate materials. Two different geosynthetic materials (75 micron) tested at a filtration rate of 0.7 m/h yielded 30-45% reduction in turbidity with relatively minor head loss. It was found that the non-woven geotextile Propex 1701 retained the highest performance in both filtration efficiency and head loss across the varying turbidity ranges in comparison to other geotextiles tested. With 5 layers of the Propex 1701 an average percent reduction of approximately 67% was achieved with a head loss average of 4mm over the two and half hour testing period. Using the data collected for the Propex 1701 a mathematical model was developed for predicting the expected percent reduction given the ability to control the cost and as a result the number of layers to be used in a given filtration scenario.

Southern New England Social and Community Plan 2009 - Covering Local Government Authorities: Armidale Dumaresq, Guyra, Uralla and Walcha

The Southern New England (SNE) Social and Community Plan is a guide to collaborative, integrated planning involving the three spheres of government, the community and commercial sectors. The Plan is based on social justice principles such as: • Equity - fairness in resource distribution, particularly for those most in need • Access - fairer access for everyone to the economic resources and services essential to meeting their basic needs and improving their quality of life • Rights - recognition and promotion of civil rights • Participation - better opportunities for genuine participation and consultation about decisions affecting people's lives. The Plan is also aimed at improving the accountability of decision-makers, and should help the councils, in conjunction with their communities meet the state government's social justice commitments. Preparation of a social and community plan is required at least every five years, and as with most councils, Armidale Dumaresq Council (ADC) has produced two already, one in 1999 and one in 2004, following the amalgamation of the former Armidale City and Dumaresq Shire Councils in 2000. Those Councils formerly prepared their own Plans in 1999, based on shared consultancy work on a community profile. This is the first joint Southern New England Plan, featuring Armidale Dumaresq, Walcha, Uralla and Guyra Councils. This Social Plan has aimed to identify and address the needs of the local community by: • describing who makes up the community • summarising key priority issues • assessing the effectiveness of any previous plans • recommending strategic ways for council and other government and non-government agencies to met community needs.

Socially inclusive learning in a community setting

People with mental health problems, learning difficulties and poor literacy and numeracy are at risk of social exclusion including homelessness. They are often disconnected from the Vocational Education and Training (VET) system, with few opportunities for education and employment. Academic research has demonstrated a link between literacy and numeracy and social inclusion, however, the pathways to enact this are not well understood. This report presents insights into how a community based adult literacy program in West End, Brisbane, was first established and has since evolved into a successful model of what we are calling ‘socially inclusive learning’. The research informing the report was conducted as a twelve-month study from April 2013 to April 2014 funded through a partnership involving Anglicare Southern Queensland, A Place to Belong and the School of Public Health and Social Work, Queensland University of Technology. The research was conducted by Greg Marston and Jeffrey Johnson- Abdelmalik. The aim of the study was to clarify the principles, practice and methodology of the Reading and Writing group (hereafter RAW) and identify the characteristics of RAW that support the social inclusion of the individual being provided literacy learning. The questions guiding the research included: • What are the key principles and practices of the RAW model? • How does the acquisition of literacy and numeracy skills contribute to the recovery of people with mental health and other issues? • How can the acquisition of literacy and numeracy skills support people’s social inclusion, including achieving employment and further education outcomes? A related aim of the project was to document how this community based literacy and numeracy program operates so that other organisations with an interest in addressing similar needs can learn from the model, particularly organisations that co-locate support and education and organisations that adopt a recovery approach when working with people with mental health challenges and intellectual and psychiatric disabilities. The report highlights the background to RAW, the learning philosophy of RAW, the profile of the participants in the program and the various roles and responsibilities and structure that supports the work of RAW. The report presents perspectives from the teachers, student participants and tutors on how the group is designed and the principles implemented.

Happiness online : supporting the emotions of emergent teachers in a virtual community

Extending Lash and Urry's (1994) notion of new "imagined communities" through information and communication structures, I ask the question: Are emergent teachers happy when they interact in online learning environments? This question is timely in the context of the ubiquity of online media and its pervasiveness in teachers' everyday work and lives. The research is important nationally and internationally, because the current research is contradictory. On the one hand, feelings of isolation and frustration have been cited as common emotions experienced in many online environments (Su, Bonk, Magjuka, Liu, & Lee, 2005). Yet others report that online communities encourage a sense of belonging and support (Mills, 2011). Emotions are inherently social, are central to learning and online interaction (Shen, Wang, & Shen, 2009). The presentations reports the use of e-motion blogs to explore emotional states of emergent primary teachers in an online learning context as they transition into their first field experience in schools. The original research was conducted with a graduate class of 64 secondary science pre-service teachers in Science Education Curriculum Studies in a large Australian university, including males and females from a variety of cultural backgrounds, aged 17-55 years. Online activities involved the participants watching a series of streamed live lectures within a course of 8 weeks duration, providing a varied set of learning experiences, such as viewing live teaching demonstrations. Each week, participants provided feedback on learning by writing and posting an e-motion diary or web log about their emotional response. The blogs answered the question: What emotions you experience during this learning experience? The descriptive data set included 284 online posts, with students contributing multiple entries. The Language of Appraisal framework, following Martin and White (2005), was used to cluster the discrete emotions within six affect groups. The findings demonstrated that the pre-service teachers' emotional responses tended towards happiness and satisfaction within the typology of affect groups - un/happiness, in/security, and dis/satisfaction. Fewer participants reported that online learning mode triggered negative feelings of frustration, and when this occurred, it often pertained expectations of themselves in the forthcoming field experience in schools or as future teachers. The findings primarily contribute new understanding about emotional states in online communities, and recommendations are provided for supporting the happiness and satisfaction of emergent teachers as they interact in online communities. It demonstrates that online environments can play an important role in fulfilling teachers' need for social interaction and inclusion.

A model predictive approach for community battery energy storage system optimization

This paper presents an efficient algorithm for optimizing the operation of battery storage in a low voltage distribution network with a high penetration of PV generation. A predictive control solution is presented that uses wavelet neural networks to predict the load and PV generation at hourly intervals for twelve hours into the future. The load and generation forecast, and the previous twelve hours of load and generation history, is used to assemble load profile. A diurnal charging profile can be compactly represented by a vector of Fourier coefficients allowing a direct search optimization algorithm to be applied. The optimal profile is updated hourly allowing the state of charge profile to respond to changing forecasts in load.

Plant diversity predicts beta but not alpha diversity of soil microbes across grasslands worldwide

Aboveground–belowground interactions exert critical controls on the composition and function of terrestrial ecosystems, yet the fundamental relationships between plant diversity and soil microbial diversity remain elusive. Theory predicts predominantly positive associations but tests within single sites have shown variable relationships, and associations between plant and microbial diversity across broad spatial scales remain largely unexplored. We compared the diversity of plant, bacterial, archaeal and fungal communities in one hundred and forty-five 1 m2 plots across 25 temperate grassland sites from four continents. Across sites, the plant alpha diversity patterns were poorly related to those observed for any soil microbial group. However, plant beta diversity (compositional dissimilarity between sites) was significantly correlated with the beta diversity of bacterial and fungal communities, even after controlling for environmental factors. Thus, across a global range of temperate grasslands, plant diversity can predict patterns in the composition of soil microbial communities, but not patterns in alpha diversity.

The feasibility of a community pharmacy delivered in-pharmacy influenza vaccination service

Pharmacist-administered vaccination is a reality in many counties including USA, Canada, UK, Portugal, Ireland and New Zealand. In Australia the role of pharmacist administered vaccination has long been supported by the profession particularly the Pharmaceutical Society of Australia and Pharmacy Guild of Australia, however legislation prohibits this practice in each state and territory. In 2013 the only available in-pharmacy vaccination services are those delivered by an immunization nurse, nurse practitioner or general practitioner.

Spatial and temporal variability in a residual soil profile

It is well understood that that there is variation inherent in all testing techniques, and that all soil and rock materials also contain some degree of natural variability. Less consideration is normally given to variation associated with natural material heterogeneity within a site, or the relative condition of the material at the time of testing. This paper assesses the impact of spatial and temporal variability upon repeated insitu testing of a residual soil and rock profile present within a single residential site over a full calendar year, and thus range of seasonal conditions. From this repeated testing, the magnitude of spatial and temporal variation due to seasonal conditions has demonstrated that, depending on the selected location and moisture content of the subsurface at the time of testing, up to a 35% variation within the test results can be expected. The results have also demonstrated that the completed insitu test technique has a similarly large measurement and inherent variability error and, for the investigated site, up to a 60% variation in normalised results was observed. From these results, it is recommended that the frequency and timing of insitu tests should be considered when deriving geotechnical design parameters from a limited data set.