Hong Kong Summer Service Program (July 4-August 12, 2005)

Now in its second year, the Hong Kong Summer Service Program is sponsored by the Lingnan Foundation, and administered by the Institute of International Education (IIE) and the Asia-Pacific Institute of Ageing Studies (APIAS). After undergoing a competitive application and interview process organized by lIE, six students from Lingnan University, Sun Yat-sen University and Lingnan (University) College were selected to participate in the program, which involves a 6-week summer internship with a community/ social service organization in Hong Kong. The Hong Kong Summer Service interns were placed in a non-profit organization that addresses a social concern related to their interests. With support and guidance from APIAS, each Fellow worked in their placement organization for the duration of the program, gaining practical experience in the operation of a social service organization. They worked with executives and administrators to learn all aspects of the operation of the organization as well as doing hands on work in the services provided by the organization. To enhance their program experience, interns worked with their organization and APIAS supervisor to propose and initiate at least one service project during their internship. This year, projects undertaken by the interns included creative art classes for children, intergenerational bridge-building activities between children and the elderly, and an outing to Lingnan University for residents of a local elderly home. Interns were required to submit program proposals, budgets and reports for their chosen projects. In addition to presenting their findings at the closing seminar, after the conclusion of the program interns submit final evaluation reports, detailing their experiences, findings and results of their internship

Impact of a mobile phone and web program on symptom and functional outcomes for people with mild-to-moderate depression, anxiety and stress: a randomised controlled trial.

Background Mobile phone-based psychological interventions enable real time self-monitoring and self-management, and large-scale dissemination. However, few studies have focused on mild-to-moderate symptoms where public health need is greatest, and none have targeted work and social functioning. This study reports outcomes of a CONSORT-compliant randomised controlled trial (RCT) to evaluate the efficacy of myCompass, a self-guided psychological treatment delivered via mobile phone and computer, designed to reduce mild-to-moderate depression, anxiety and stress, and improve work and social functioning. Method Community-based volunteers with mild-to-moderate depression, anxiety and/or stress (N= 720) were randomly assigned to the myCompass program, an attention control intervention, or to a waitlist condition for seven weeks. The interventions were fully automated, without any human input or guidance. Participants’ symptoms and functioning were assessed at baseline, post-intervention and 3-month follow-up, using the Depression, Anxiety and Stress Scale and the Work and Social Adjustment Scale. Results Retention rates at post-intervention and follow-up for the study sample were 72.1% (n= 449) and 48.6% (n= 350) respectively. The myCompass group showed significantly greater improvement in symptoms of depression, anxiety and stress and in work and social functioning relative to both control conditions at the end of the 7-week intervention phase (between-group effect sizes ranged from d= .22 to d= .55 based on the observed means). Symptom scores remained at near normal levels at 3-month follow-up. Participants in the attention control condition showed gradual symptom improvement during the post-intervention phase and their scores did not differ from the myCompass group at 3-month follow-up. Conclusions The myCompass program is an effective public health program, facilitating rapid improvements in symptoms and in work and social functioning for individuals with mild-to-moderate mental health problems

Sharing risk management: an implementation model for cardiovascular absolute risk assessment and management in Australian general practice

Purpose: Despite considerable work in developing and validating cardiovascular absolute risk (CVAR) algorithms, there has been less work on models for their implementation in assessment and management. The aim of our study was to develop a model for a joint approach to its implementation based on an exploration of views of patients, general practitioners (GPs) and key informants (KIs). Methods: We conducted six focus group (three with GPs and three with patients) and nine KI interviews in Sydney. Thematic analysis was used with comparison to highlight the similarities and differences in perspectives of participants. Results: Conducting CVAR was seen as more acceptable for regular patients rather than new patients for whom GPs had to attract their interest and build rapport before doing so at the next visit. GPs' interest and patients' positive attitude in managing risk were important in implementing CVAR. Long consultations, good communication skills and having a trusting relationship helped overcome the barriers during the process. All the participants supported engaging patients to self-assess their risk before the consultation and sharing decision making with GPs during consultation. Involving practice staff to help with the patient self-assessment, follow-up and referral would be helpful in implementing CVAR assessment and management, but GPs, patients and practices may need more support for this to occur. Conclusions: Multiple strategies are required to promote the better use of CVAR in the extremely busy working environment of Australian general practice. An implementation model has been developed based on our findings and the Chronic Care Model. Further research needs to investigate the effectiveness of the proposed model

Exploring the evidence base for how people with dementia and their informal carers manage their medication in the community:a mixed studies review

BACKGROUND: Little is known about the general medicines management issues for people with dementia living in the community. This review has three aims: firstly to explore and evaluate the international literature on how people with dementia manage medication; assess understanding of medicines management from an informal carers perspective; and lastly to understand the role that healthcare professionals play in assisting this population with medicines management. METHODS: A mixed studies review was conducted. Web of Knowledge, PubMed and Cochrane Library were searched post-1999 for studies that explored medicines management in people with dementia dwelling in the community, and the role healthcare professionals play in supporting medicines management in people with dementia. Following screening, nine articles were included. Data from included studies were synthesised using a convergent synthesis approach and analysed thematically to combine findings from studies using a range of methods (qualitative, quantitative and mixed methods). RESULTS: Four themes were generated from the synthesis: The nature of the disease and the effects this had on medicines management; the additional responsibilities informal carers have; informal caregivers' knowledge of the importance of managing medication and healthcare professionals' understanding of medicines management in people with dementia. Consequently, these were found to affect management of medication, in particular adherence to medication. CONCLUSIONS: This review has identified that managing medication for people with dementia dwelling in the community is a complex task with a frequently associated burden on their informal caregivers. Healthcare professionals can be unaware of this burden. The findings warrant the need for healthcare professionals to undergo further training in supporting medicines management for people with dementia in their own homes

Healthy aging and the University of the Third Age – Health behavior and subjective health outcomes in older adults

Introduction: By participating in the University of the Third Age (U3A), retirees are offered the opportunity for activation and development in the later years of life. However, little is known how certain aspects of healthy aging, such as health-related behavior and subjective health outcomes, differ between U3A students and other older adults not taking part in any form of education. To address this, the aim of the present study was to compare selected aspects of healthy aging in a group of U3A members with older adults not taking part in any form of lifelong learning. The study also establishes relationships between the tested variables and predictors of health behavior. Materials and methods: 277 older adults (130 U3A members and 147 non-members) aged 60–92 (M = 68.84, SD = 5.32) completed measures of health behavior, self-rated physical health, self-rated sense of own health responsibility and satisfaction with life. Results: The U3A attendees presented significantly higher scores for general health behavior and some of its components, and declared higher self-rated health than their peers not affiliated to any educational organization. Self-rated health, responsibility for health and satisfaction with life were positively correlated with general health behavior and most of their categories. but the correlation coefficients differed between both groups. A hierarchical regression model demonstrated the predictive roles of attendance in U3A, sociodemographic and subjective factors in health behavior undertaking. Conclusions: The study results may help to identify older adults who should be targeted in interventions aimed at supporting healthy aging

What's law got to do with it Part 2: Legal strategies for healthier nutrition and obesity prevention

This article is the second in a two-part review of law's possible role in a regulatory approach to healthier nutrition and obesity prevention in Australia. As discussed in Part 1, law can intervene in support of obesity prevention at a variety of levels: by engaging with the health care system, by targeting individual behaviours, and by seeking to influence the broader, socio-economic and environmental factors that influence patterns of behaviour across the population. Part 1 argued that the most important opportunities for law lie in seeking to enhance the effectiveness of a population health approach