Nation-state belonging among Asian Australians and the question of transnationalism

Research shows that migrants are likely to develop multiple attachments to local and global allegiances that lie beyond the boundaries of the nation-state. Drawing on the Asian Australian experience as a point of departure, this article explores whether Asian Australian migrants from a range of different social and cultural backgrounds are more or less likely than the rest of the Australian population to feel a sense of belonging to the nation-state. Using the Australian Survey of Social Attitudes 2003, the results show that Asian Australian migrants have similar views towards the nation-state as the rest of the Australian population. Given that research on the Asian Australian migrant experience is predominantly located in cultural studies, the results suggest the importance of using survey research as another avenue to understand the migrant experience.

Assessment of indigenous older peoples ’ needs for home and community care in remote central Australia

The Home and Community Care (HACC) program in Australia provides services which supports older people to live at home. Individual HACC organisations are generally responsible for initial assessment of eligibility and need of clients presenting for services. This paper reports on a project which aimed to develop an understanding of the various approaches to assessment of client needs in Central Australia. The majority of clients in this geographical area are indigenous. The project was initiated in recognition of the primary importance of assessment in determining service access and service delivery and of the particular challenges faced by service providers in remote areas. This paper discusses key project findings including the client group and services provided, initial needs assessment and care planning processes. Evident inconsistencies in practice reflect a variety of complex contextual factors. Staff in remote areas have an inadequate knowledge base to draw upon to assist them with assessment and care planning decisions, and further research and professional development is required.

Ethnic aged discrimination and disparities in health and social care : a question of social justice

Older overseas-born Australians of diverse cultural and language backgrounds experience significant disparities in their health and social care needs and support systems. Despite being identified as a 'special needs' group, the ethnic aged in Australia are generally underserved by local health and social care services, experience unequal burdens of disease and encounter cultural and language barriers to accessing appropriate health and social care compared to the average Australian-born population. While a range of causes have been suggested to explain these disparities, rarely has the possibility of cultural racism been considered. In this article, it is suggested that cultural racism be named as a possible cause of ethnic aged disparities and disadvantage in health and social care. It is further suggested that unless cultural racism is named as a structural mechanism by which ethnic aged disparities in health and social care have been created and maintained, redressing them will remain difficult.

Knowledge and skills of professional carers working with older people with depression

Objectives: The current study was designed to evaluate the knowledge, skills and self-efficacy of care providers from the perspective of professionals working in the aged-care industry.

Method: Participants were 21 professional carers, 10 General Practitioners and 7 aged-care managers. Focus groups, which involved the completion of a semi-structured interview related to knowledge, recognition, confidence, referral procedures and use of screening tools for the detection of depression, were conducted.

Results: The results showed that all groups of respondents recognised significant gap in the knowledge and awareness of depression among professional care staff working with older people in both the community and residential care-settings. Skills in the detection and monitoring of depression and the self-efficacy of these care staff were also seen to be a problem.

Discussion: The implications of these findings in terms of training programmes for professional carers working in the aged health care sector are discussed.

Effects of a multi-component exercise program and calcium–vitamin-D3-fortified milk on bone mineral density in older men : a randomised controlled trial

Summary We examined the independent and combined effects of a multi-component exercise program and calcium–vitamin-D3-fortified milk on bone mineral density (BMD) in older men. Exercise resulted in a 1.8% net gain in femoral neck BMD, but additional calcium–vitamin D3 did not enhance the response in this group of older well-nourished men.

Introduction This 12-month randomised controlled trial assessed whether calcium–vitamin-D3-fortified milk could enhance the effects of a multi-component exercise program on BMD in older men.

Methods Men (n  = 180) aged 50–79 years were randomised into: (1) exercise + fortified milk; (2) exercise; (3) fortified milk; or (4) controls. Exercise consisted of high intensity progressive resistance training with weight-bearing impact exercise. Men assigned to fortified milk consumed 400 mL/day of low fat milk providing an additional 1,000 mg/day calcium and 800 IU/day vitamin D3. Femoral neck (FN), total hip, lumbar spine and trochanter BMD and body composition (DXA), muscle strength 25-hydroxyvitamin D and parathyroid hormone (PTH) were assessed.

Results There were no exercise-by-fortified milk interactions at any skeletal site. Exercise resulted in a 1.8% net gain in FN BMD relative to no-exercise (p < 0.001); lean mass (0.6 kg, p < 0.05) and muscle strength (20–52%, p < 0.001) also increased in response to exercise. For lumbar spine BMD, there was a net 1.4–1.5% increase in all treatment groups relative to controls (all p < 0.01). There were no main effects of fortified milk at any skeletal site.

Conclusion A multi-component community-based exercise program was effective for increasing FN BMD in older men, but additional calcium–vitamin D3 did not enhance the osteogenic response.

Staying connected : the lived experiences of volunteers and older adults

Many housebound older adults lack meaningful social relationships. In this study we explore the phenomenon of social connectedness in the volunteer-older adult relationship through the experiences of frail and isolated older adults and volunteers. We conceptualise this relationship as a journey whereby each traveller plays an active role in its direction and outcome. The emergent phenomenological essence of social connectedness from these dyad’s narratives provides meaning for both differences and similarities into the way the construct is conceptualised. When volunteers maintain the boundaries of the relationship through structured conversation and visits, it is described as friendly. Transgressing the boundaries involves doing extra for the elder and is both a function of the dyad’s compatibility, and the volunteer’s sense of ongoing agency and lack of elder expectations. The sense of social connectedness inherent in these relationships often feels like that of friendship or family, and these relationships are perceived as meaningful and close for both parties. Social connectedness in family-like relationships is a function of the playing out of an otherwise missing family role. However, if volunteer volition is compromised, this results in feelings of obligation and responsibility, similar to the dynamic between blood relatives. Participants’ narratives suggest that when the boundaries of the relationship are mutually negotiated, this serves to strengthen the relationship’s socioemotional quality, and potential for the continuity of the unique sense of social connectedness that has already been established.

The skeletal benefits of calcium- and vitamin D3-fortified milk are sustained in older men after withdrawal of supplementation: an 18 mo follow-up study

Background: In a previous 2-y randomized controlled trial, we showed that calcium- and vitamin D₃–fortified milk stopped or slowed bone loss at several clinically relevant skeletal sites in older men.

Objective: The present study aimed to determine whether the skeletal benefits of the fortified milk were sustained after withdrawal of the supplementation.

Design: One hundred nine men >50 y old who had completed a 2-y fortified milk trial were followed for an additional 18 mo, during which no fortified milk was provided. Bone mineral density (BMD) of the total hip, femoral neck, lumbar spine, and forearm was measured by using dual-energy X-ray absorptiometry.

Results: Comparison of the mean changes from baseline between the groups (adjusted for baseline age, BMD, total calcium intake, and change in weight) showed that the net beneficial effects of fortified milk on femoral neck and ultradistal radius BMD at the end of the intervention (1.8% and 1.5%, respectively; P < 0.01 for both) were sustained at 18-mo follow-up (P < 0.05 for both). The nonsignificant between-group differences at the total hip (0.8%; P = 0.17) also persisted at follow-up (0.7%; P = 0.10), but there were no lasting benefits at the lumbar spine. The average total dietary calcium intake in the milk supplementation group at follow-up approximated recommended amounts for Australian men >50 y old (1000 mg/d) but did not differ significantly from that in the control subjects (1021 versus 890 mg/d).

Conclusion: Supplementation with calcium- and vitamin D₃–fortified milk for 2 y may provide some sustained benefits for BMD in older men after withdrawal of supplementation.

Older people's relationships with companion animals : a pilot study

When older people enter residential care facilities, disruption to social networks may occur, with detrimental effects on health and wellbeing. This article reports on a study undertaken in an aged care facility in Melbourne, Australia, that explored the potential for a visiting companion animal programme to improve the health and wellbeing of residents and to promote their capacity for building relationships. Results back assertions in the literature that companion animals foster relationships by giving people opportunities to interact with others, but further study is needed to verify the link