Advance care planning in 21st century Australia: a systematic review and appraisal of online advance care directive templates against national framework criteria

Objectives A drive to promote advance care planning at a population level has led to a proliferation of online advance care directive (ACD) templates but little information to guide consumer choice. The current study aimed to appraise the quality of online ACD templates promoted for use in Australia. Methods A systematic review of online Australian ACD templates was conducted in February 2014. ACD templates were identified via Google searches, and quality was independently appraised by two reviewers against criteria from the 2011 report A National Framework for Advance Care Directives. Bias either towards or against future medical treatment was assessed using criteria designed to limit subjectivity. Results Fourteen online ACD templates were included, all of which were available only in English. Templates developed by Southern Cross University best met the framework criteria. One ACD template was found to be biased against medical treatment – the Dying with Dignity Victoria Advance Healthcare Directive. Conclusions More research is needed to understand how online resources can optimally elicit and record consumers’ individual preferences for future care. Future iterations of the framework should address online availability and provide a simple rating system to inform choice and drive quality improvement

The co-creation of social ventures through bricolage, for the displaced, by the displaced

Purpose Although scholars have investigated how social entrepreneurs create and develop social enterprises in the penurious stable environment, how they are created in the penurious unstable environment has yet been overlooked. The purpose of this paper is to address this research gap by exploring how internally displaced individuals, despite the lack of resources, create and develop a social enterprise to serve the other displaced population in the war and conflict zones. Design/methodology/approach Underpinned by a biographical research design, in-depth interviews with internally displaced individuals who have created social enterprises in the war and conflict zones were undertaken. Three social entrepreneurs were chosen for this study from three different social enterprises that are created by internally displaced individuals to serve the other internally displaced people of three different countries, namely, Pakistan, Afghanistan and Syria. Findings The single and cross-case analysis found that internally displaced individuals deploy bricolage strategy, for example, reconfiguration of pre-existing resources and competencies (both internal and external), to start up a social venture in the war and conflict zones. They utilise pre-existing internal resources, mainly human capital, and external resources, through a frugal approach towards resources acquisitions. The authors also found that the displaced social entrepreneurs utilise resources of other displaced individuals, for example, networks, volunteers, local knowledge and financial supports mainly from older arrivals, and develop their own enterprise ecosystem within the host location to co-create and co-develop social enterprise and social values for all of them. Research limitations/implications The findings show that internally displaced individuals utilise bricolage strategies to create and develop socially entrepreneurial venture to serve other internally displaced individuals in the war and conflict zones. As the findings are based on three case studies, for confirmatory approach, a quantitative study with a large sample size is necessary. Furthermore, as the differences in economic, cultural and linguistic in between the home and host locations can have impact on the creation and the development of a social venture, they should be considered in the future studies. Originality/value This study contributes to the limited literature and studies on social entrepreneurship, specifically, to the context of unstable penurious environment. It also contributes to the literature on bricolage by extending its application from penurious stable environment to the penurious unstable environment. By exploring what and how internal and external resources are utilised to create and develop a socially entrepreneurial venture in a war and conflict zones, this study has added value to the literature on not only bricolage but also entrepreneurship in war and conflict zones

Effect of off-center ion substitution in morphotropic lead zirconate titanate

This research was supported by the DOD Grant No. FA9550–16-1–0295. S.P.P. gratefully acknowledges the financial assistance from IFN-NSF under the Grant No. EPS-1002410.A detailed study of the effect of off-center donor ion (Sc3+) substitution on structural, microstructural, optical, dielectric, electrical and ferroelectric properties of morphotropic lead zirconate titanate electroceramics with the stoichiometric formula Pb0.85Sc0.10Zr0.53Ti0.47O3 (PSZT), synthesized using a high-energy solid-state reaction technique, was carried out. Powder x-ray diffractometry was used to identify the stabilized tetragonal phase (space group P4mm) with considerably reduced tetragonal strain, c/a = 1.005. An analysis of the thermal dependence of the Raman results indicated a smooth order-disorder displacive (ferroelectric-paraelectric) phase transition as revealed by the observed disappearance of the soft modes A1 (1TO) and A1 (2TO) above 460 K. The dielectric response of Pt/PSZT/Pt metal-ferroelectric-metal (MFM) capacitors was probed over a wide range of thermal excursions (85-600 K) and ac signal frequencies (102-106 Hz). Thermally activated dynamic and static conduction processes indicate hopping conduction mechanism (Eact ≤ 0.015 eV) and the formation of small polarons caused by the electron and/or hole-lattice (phonon) interaction (Eact ≥ 0.1 eV) at low (100−300 K) and high temperatures (300−600 K), respectively. The reduction in remnant polarization obtained is in good agreement with the largely reduced tetragonal strain observed in this sample, ( Pr ∝√(c/a-1) ). DC current conduction is dominated by Poole-Frenkel mechanism that assumes a Coulombic attraction between de-trapped electrons and positively charged stationary defects in the polycrystalline matrix.PostprintPeer reviewe

Process Documentation Research and Impact of Community-Driven Development Grants Research in Rural India, Socioeconomics Discussion Paper Series 34

In 2011 ICRISAT gave experimental grants to six dryland villages targeted by the “Village Dynamics Studies in South Asia” (VDSA) project. Two villages were located in Telangana state (undivided Andhra Pradesh) and four in Maharashtra state. A grant of USD 7,000 (Rs. 315,000) was given to each villages to assess the role of local governance and institutions on agricultural performance, and to evaluate development pathways. The community was free to decide where and how to use the grant. Using the Process Documentation Research (PDR) framework, this report documents the activities of the ICRISAT-VDSA project team and the community implementation committee in using the grant, and lessons learned in the process. We also estimated the number of beneficiaries and the economic benefits from the grant. In two villages, the annual economic benefits from the grant were almost equal to the total grant expenditure. In five villages, the cumulative benefits over the last four years exceeded the total value of the grant. Unlike other publically-funded projects, large numbers of households from minority and socially weaker sections also benefited. The results suggest that, given the opportunity, local communities can effectively execute local infrastructure development projects through need-based collective action, while lowering the transaction costs of community action. By involving local community members in planning and implementing projects, the village grant provided benefits to a large number of households and generated substantial economic benefits. The experiment provides useful lessons for scaling-out village grants to other project villages, and for rural development agencies in India and elsewhere

Effectiveness of interventions to promote healthy diet in primary care: systematic review and meta-analysis of randomised controlled trials

Background A diet rich in fruit, vegetables and dietary fibre and low in fat is associated with reduced risk of chronic disease. This review aimed to estimate the effectiveness of interventions to promote healthy diet for primary prevention among participants attending primary care.<p></p> Methods A systematic review of trials using individual or cluster randomisation of interventions delivered in primary care to promote dietary change over 12 months in healthy participants free from chronic disease or defined high risk states. Outcomes were change in fruit and vegetable intake, consumption of total fat and fibre and changes in serum cholesterol concentration.<p></p> Results Ten studies were included with 12,414 participants. The design and delivery of interventions were diverse with respect to grounding in behavioural theory and intervention intensity. A meta-analysis of three studies showed an increase in fruit consumption of 0.25 (0.01 to 0.49) servings per day, with an increase in vegetable consumption of 0.25 (0.06 to 0.44) serving per day. A further three studies that reported on fruit and vegetable consumption together showed a pooled increment of 0.50 (0.13 to 0.87) servings per day. The pooled effect on consumption of dietary fibre, from four studies, was estimated to be 1.97 (0.43 to 3.52) gm fibre per day. Data from five studies showed a mean decrease in total fat intake of 5.2% of total energy (1.5 to 8.8%). Data from three studies showed a mean decrease in serum cholesterol of 0.10 (-0.19 to 0.00) mmol/L.<p></p> Conclusion Presently-reported interventions to promote healthy diet for primary prevention in primary care, which illustrate a diverse range of intervention methods, may yield small beneficial changes in consumption of fruit, vegetables, fibre and fat over 12 months. The present results do not exclude the possibility that more effective intervention strategies might be developed.<p></p&gt

High Effective Coverage of Vector Control Interventions in Children After Achieving Low Malaria Transmission in Zanzibar, Tanzania.

\ud \ud Formerly a high malaria transmission area, Zanzibar is now targeting malaria elimination. A major challenge is to avoid resurgence of malaria, the success of which includes maintaining high effective coverage of vector control interventions such as bed nets and indoor residual spraying (IRS). In this study, caretakers' continued use of preventive measures for their children is evaluated, following a sharp reduction in malaria transmission. A cross-sectional community-based survey was conducted in June 2009 in North A and Micheweni districts in Zanzibar. Households were randomly selected using two-stage cluster sampling. Interviews were conducted with 560 caretakers of under-five-year old children, who were asked about perceptions on the malaria situation, vector control, household assets, and intention for continued use of vector control as malaria burden further decreases. Effective coverage of vector control interventions for under-five children remains high, although most caretakers (65%; 363/560) did not perceive malaria as presently being a major health issue. Seventy percent (447/643) of the under-five children slept under a long-lasting insecticidal net (LLIN) and 94% (607/643) were living in houses targeted with IRS. In total, 98% (628/643) of the children were covered by at least one of the vector control interventions. Seasonal bed-net use for children was reported by 25% (125/508) of caretakers of children who used bed nets. A high proportion of caretakers (95%; 500/524) stated that they intended to continue using preventive measures for their under-five children as malaria burden further reduces. Malaria risk perceptions and different perceptions of vector control were not found to be significantly associated with LLIN effective coverage While the majority of caretakers felt that malaria had been reduced in Zanzibar, effective coverage of vector control interventions remained high. Caretakers appreciated the interventions and recognized the value of sustaining their use. Thus, sustaining high effective coverage of vector control interventions, which is crucial for reaching malaria elimination in Zanzibar, can be achieved by maintaining effective delivery of these interventions