Enhancing the lives of older refugees: an evaluation of a training resource.

BACKGROUND: Resources and training for aged care workers who are working with older people from refugee backgrounds are limited. Thus, a resource titled 'Enhancing the Lives of Older Refugees: A self-Improvement Resource for Community Service Providers' was developed in 2011, and later accompanied by a training program developed in 2012. The aim of the resource and accompanying training was to assist community aged care service providers, based in South Western Sydney and surrounding areas, to recognise an older refugee, increase their knowledge and skills in working with older refugees, have a greater understanding of older refugees' life experiences, and provide additional information that would allow them to offer appropriate services to those in their care. This paper reports on the evaluation of the training package provided to community aged care personnel. METHODS: Eleven training sessions were conducted with all participants invited to take part in the research. One hundred and twenty-eight consenting participants completed a pre and post training evaluation questionnaire. RESULTS: Analysis of the data indicated a positive change in participant's ability to define an older refugee, understanding older refugee's life experiences, loss and grief, the impact of the refugees' experience in old age and the capacity to locate and access information to support the care of older refugees. CONCLUSIONS: The findings lend support that this mode of training can provide information and resources to increase the capacity of aged care workers to better meet the needs of older people from a refugee background.

Reclaiming the best of the biopsychosocial model of mental health care and 'recovery' for older people through a 'person-centred' approach.

AIM: The 'biopsychosocial', 'person-centred care' (PCC) and 'recovery' models of care can be seen as distinct and competing paradigms. This paper proposes an integration of these valuable perspectives and suggestions for effective implementation in health services for the elderly. METHOD: An overview of PCC and recovery models, and their application for older people with mental health problems, is provided. Their overlap and contrast with the familiar 'biopsychosocial' model of mental health care is considered, together with obstacles to implementation. RESULTS: Utilisation of PCC and recovery concepts allow clinicians to avoid narrow application of the biopsychosocial approach and encourages clinicians to focus on the person's right to autonomy, their values and life goals. CONCLUSIONS: Service reform and development is required to embed these concepts into core clinical processes so as to improve outcomes and the quality of life for older people with mental health problems.

Benchmarking older persons mental health organizations.

OBJECTIVE: This paper offers a reflection about the outcomes of the older persons benchmarking forums that formed part of the National Mental Health Benchmarking Project (NMHBP). METHOD: Seven older persons mental health organizations took part in the NMHBP. Representatives from these organizations attended eight benchmarking forums at which they documented their performance against relevant key performance indicators (KPIs). In order to better understand the differential performance of organizations on particular KPIs, participants gathered additional contextual data. This included organization-level data, data on the local catchment area, and data with which to profile the consumers accessing services through the given organization. RESULTS: Participants' average performance on some indicators was stable over time, while the average performance on others demonstrated fluctuations. Perhaps more importantly, the inter-organization range for almost all of the indicators was substantial. CONCLUSIONS: The older persons benchmarking forums provided an opportunity for participants to gauge the performance of their own organizations on a range of KPIs, come to understand some of the reasons for their own organization's performance and that of their counterparts, consider which of these reasons may be within their control, and reflect upon opportunities for quality improvement within their own organizations.

Exploration of social support systems for older adults: a preliminary study.

OBJECTIVES: To explore the lived experience of older adults participating regularly in a social support network group in the community. METHOD: Hermeneutic phenomenology was employed for this preliminary study as little was known about the lived experience of older adults engaged with peers. Six older adults, four females and two males, volunteered to participate in a focus group interview for the purpose of testing interview techniques and questions and to examine alternative lines of enquiry for subsequent interviews. The group interview was transcribed verbatim and analysed to gain meaning of the phenomena under study. FINDINGS: Being a member of a group, where peer support was experienced, was extremely important and this support assisted in the maintenance of physical and psychological well-being of individual group members. CONCLUSION: As a result of this study a greater understanding of what is meaningful to older adults in terms of social support, and the importance of network systems and peer contact was made clearer. By appreciating the need for older adults to engage regularly in a support group with their peers, nurses, and other healthcare professionals can promote the health of older adults for whom they provide care. Interview techniques were perceived to be appropriate.

Expensive detour or a way forward? The experience of routine outcome measurement in an aged care psychiatry service.

OBJECTIVE: This paper describes and reflects upon the experience of a small, integrated aged care psychiatry service that has utilized the National Outcomes Casemix Collection (NOCC) routine outcome measurements within clinical practice, service management and evaluation. The goals of the NOCC initiative are reviewed in light of this experience. CONCLUSION: Routine outcome measurement has the potential to significantly improve aged care psychiatric service delivery. The service described has developed a model that the authors believe demonstrates the potential for routine outcome measures to improve the monitoring of patient progress, care planning, team communication, management and the understanding of service effectiveness - goals that are consistent with NOCC philosophy. However, this requires both ongoing development of infrastructure support and the willingness of clinicians to explore their utility.

Can commercial peanut assay kits detect peanut allergens?

Peanut is the food group mostly associated with severe and fatal allergic reactions. In the United States, more than 90% of peanut-allergic individuals' serum IgE recognized peanut proteins Ara h 1 and Ara h 2, thus establishing these proteins as major peanut allergens. The amount of Ara h 1 and Ara h 2 in 3 varieties of peanut cultivars that are commonly processed in the industrialized countries was determined to be 12-16 and 6-9%, respectively. Current commercial peanut test kits use polyclonal peanut-specific antibodies to detect soluble or buffer extractable peanut proteins. Because the 2 major peanut allergens Ara h 1 and Ara h 2 are isolated from soluble peanut proteins, it is generally assumed that these commercial kits can detect peanut allergens, although none of these kits claims to detect peanut allergen. This study showed for the first time that the peanut test kits could, in fact, detect major peanut allergens Ara h 1 and Ara h 2 in both native or heat-denatured structures; therefore, these kits qualified to be classified as peanut allergen enzyme-linked immunosorbent assays.

Determination of Cry9C protein in processed foods made with StarLink corn.

StarLink (Aventis CropScience US) hybrid corn has been genetically modified to contain a pesticidal protein, Cry9C, which makes it more resistant than traditional varieties to certain types of corn insect pests. Unlike other varieties of genetically engineered corn, the U.S. Environmental Protection Agency authorized the use of StarLink corn for animal feed and industrial use only, not for human consumption. However, some Cry9C-containing corn was mistakenly or inadvertently comingled with yellow corn intended for human food use. Because corn containing the Cry9C construct was not approved for human use, the U.S. Food and Drug Administration considers food containing it to be adulterated. Consequently, this regulatory violation resulted in hundreds of recalls of corn-based products, such as taco shells, containing cry9C DNA. Detecting the novel protein in StarLink corn is an emerging issue; therefore, there is no standardized or established analytical method for detecting Cry9C protein in processed foods. We developed a procedure for quantitation of Cry9C protein, with validation data, in processed food matrixes with a limit of quantitation at 1.7 ng/g (ppb), using a commercial polyclonal antibody-based Cry9C kit that was intended for corn grain samples. Intra- and interassay coefficients of variation were 2.8 and 11.8%, respectively. Mean recoveries were 73 and 85% at 2 and 5 ng/g Cry9C fortifications, respectively, for 19 control non-StarLink corn-based matrixes. Our data demonstrate only 0-0.5% of Cry9C protein survived the processing of tortilla chips and soft tortillas made from 100% StarLink corn, resulting in levels from below the detection limit to 45 ppb.