Telehealth for nursing homes: the utilization of specialist services for residential care

Specialist care consultations were identified by two research nurses using documentation in patient records, appointment diaries, electronic billing services and on-site observations at a 441-bed long term care facility. Over a six-month period there were 3333 consultations (a rate of 1511 consultations per year per 100 beds). Most consultations were for general practice (n = 2589, 78%); these consultations were mainly on site (99%), with only 27 taking place off site. There were 744 consultations for specialities other than general practice. A total of 146 events related to an emergency or unplanned hospital admission. The remaining medical consultations (n = 598, 18%) related to 23 medical specialities. The largest number of consultations were for surgery (n = 106), podiatry (n = 100), nursing services including wound care (n = 74), imaging (n = 41) and ophthalmology (n = 40). Many services which are currently being provided on site to metropolitan long-term care facilities could be provided by telehealth in both urban and rural facilities.

Educational accountability tests, social and legal inclusion approaches to discrimination for students with disability : a national case study from Australia

The UN Convention on the Rights of Persons with Disability (CRPD) promotes equal and full participation by children in education. Equity of educational access for all students, including students with disability, free from discrimination, is the first stated national goal of Australian education (MCEETYA 2008). Australian federal disability discrimination law, the Disability Discrimination Act 1992 (DDA), follows the Convention, with the federal Disability Standards for Education 2005 (DSE) enacting specific requirements for education. This article discusses equity of processes for inclusion of students with disability in Australian educational accountability testing, including international tests in which many countries participate. The conclusion drawn is that equitable inclusion of students with disability in current Australian educational accountability testing in not occurring from a social perspective and is not in principle compliant with law. However, given the reluctance of courts to intervene in education matters and the uncertainty of an outcome in any court consideration, the discussion shows that equitable inclusion in accountability systems is available through policy change rather than expensive, and possibly unsuccessful, legal challenges.

Importance of a resilient air services network to Australian remote, rural, and regional communities

Rural, regional, and remote settlements in Australia require resilient infrastructure to remain sustainable in a context characterized by frequent large-scale natural disasters, long distances between urban centers, and the pressures of economic change. A critical aspect of this infrastructure is the air services network, a system of airports, aircraft operators, and related industries that enables the high-speed movement of people, goods, and services to remote locations. A process of deregulation during the 1970s and 1980s resulted in many of these airports passing into local government and private ownership, and the rationalization of the industry saw the closure of a number of airlines and airports. This paper examines the impacts of deregulation on the resilience of air services and the contribution that they make to regional and rural communities. In particular, the robustness, redundancy, resourcefulness, and rapidity of the system are examined. The conclusion is that while the air services network has remained resilient in a situation of considerable change, the pressures of commercialization and the tendency to manage aspects of the system in isolation have contributed to a potential decrease in overall resilience.

Compensation for lost services of an employee : pure economic loss and per quod action

Under the common law an employer may take action against a defendant for the loss of an employee’s services due to the act of the defendant (per quod servitium amisit - by reason of which the services were lost). The High Court has recently affirmed the existence of this ancient tort in Barclay v Penberthy [2012] HCA 40.

Policy, citizenship and governance : the case of disability and employment policy in Australia

Current discussions regarding the relationship between welfare governance systems and employment promotion in disability policy appeal to a rejuvenated neo-liberal and paternalistic understanding of welfare governance. At the core of this rationality is the argument that people with disabilities not only have rights, but also duties, in relation to the State. In the Australia welfare system, policy tools are deployed to produce a form of self-discipline, whereby the State emphasises personal responsibility via assessment tools, ‘mutual obligation’ policy, and motivational strategies. Drawing on a two-year semi-longitudinal study with 80 people with a disability accessing welfare benefits, we examine how welfare governance subject recipients to strategies to produce productive citizens who are able to contribute to the national goal of maintaining competitiveness in the global economy. Participants’ interviews reveal the intended and unintended effects of this activation policy, including some acceptance of the logic of welfare-to-work and counter-hegemonic resistance to de-valued social identities.

Life impact of ankle fractures : qualitative analysis of patient and clinician experiences

Background: Ankle fractures are one of the more commonly occurring forms of trauma managed by orthopaedic teams worldwide. The impacts of these injuries are not restricted to pain and disability caused at the time of the incident, but may also result in long term physical, psychological, and social consequences. There are currently no ankle fracture specific patient-reported outcome measures with a robust content foundation. This investigation aimed to develop a thematic conceptual framework of life impacts following ankle fracture from the experiences of people who have suffered ankle fractures as well as the health professionals who treat them. Methods: A qualitative investigation was undertaken using in-depth semi-structured interviews with people (n=12) who had previously sustained an ankle fracture (patients) and health professionals (n=6) that treat people with ankle fractures. Interviews were audio-recorded and transcribed. Each phrase was individually coded and grouped in categories and aligned under emerging themes by two independent researchers. Results: Saturation occurred after 10 in-depth patient interviews. Time since injury for patients ranged from 6 weeks to more than 2 years. Experience of health professionals ranged from 1 year to 16 years working with people with ankle fractures. Health professionals included an Orthopaedic surgeon (1), physiotherapists (3), a podiatrist (1) and an occupational therapist (1). The emerging framework derived from patient data included eight themes (Physical, Psychological, Daily Living, Social, Occupational and Domestic, Financial, Aesthetic and Medication Taking). Health professional responses did not reveal any additional themes, but tended to focus on physical and occupational themes. Conclusions: The nature of life impact following ankle fractures can extend beyond short term pain and discomfort into many areas of life. The findings from this research have provided an empirically derived framework from which a condition-specific patient-reported outcome measure can be developed.

Enhancing public transport passenger experience via mobile-mediated applications and services

Despite the rapidly urbanising population, public transport usage in metropolitan areas is not growing at a level that corresponds to the trend. Many people are reluctant to travel using public transport, as it is commonly associated with unpleasant experiences such as limited services, long wait time, and crowded spaces. This study aims to explore the use of mobile spatial interactions and services, and investigate their potential to increase the enjoyment of our everyday commuting experience. The main goal is to develop and evaluate mobile-mediated design interventions to foster interactions for and among passengers, as well as between passengers and public transport infrastructures, with the aim to positively influence the experience of commuting. Ultimately, this study hopes to generate findings and knowledge towards creating a more enjoyable public transport experience, as well as to explore innovative uses of mobile technologies and context-aware services for the urban lifestyle.

Consumer guarantees and the supply of educational services by higher education providers

The higher education sector is undergoing a number of significant changes, the implications of which have yet to emerge. One such change is the increasing reliance by higher education providers on the revenue generated by full fee paying international students to fund their operating expenses. The report by the Victorian Ombudsman, Investigation into how Universities Deal with International Students ('Victorian Ombudsman's Report') tabled in the Victorian Parliament on 27 October 2011, provides evidence that Australian higher education providers may be failing to meet their legal obligations to international students. The Victorian Ombudsman's Report is the result of an investigation into four Victorian universities teaching international students with a focus on accounting and nursing schools. The report contains evidence that the universities were admitting students with scores below, or at the lower end of, the International English Language Testing System ('IELTS') score considered acceptable. Alternatively, they were relying upon their own language testing admission standards and not on an independent test like the IELTS test. While the universities provided English language support services for their international students after they had been admitted, the Ombudsman was concerned that the universities 'have not dedicated sufficient resources to meet the level of need amongst international students'.

Mobile valuations : the Internet's impact on traditional valuation services

Preparing valuations is a time consuming process involving site inspections, research and report formulation. The ease of access to the internet has changed how and where valuations may be undertaken. No longer is it necessary to return to the office to finalise reports, or leave your desk in order to undertake research. This enables more streamlined service delivery and is viewed as a positive. However, it is not without negative impacts. This paper seeks to inform practitioners of the work environment changes flowing from increased access to the internet. It identifies how increased accessibility to, and use of, technology and the internet has, and will continue to, impact upon valuation service provision into the future.

Evaluating the QUT Homestay Program : lessons learnt in providing quality services to international students

The QUT Homestay Program is an essential part of the university’s commitment to meet the accommodation needs of international students. Despite the importance of this style of accommodation, there is very little research addressing issues related to homestay arrangements. The program at Queensland University of Technology (QUT) was evaluated in 2002 to develop a continuous improvement framework to ensure provision of quality homestay services to international students. This paper presents an overview of the evaluation and key lessons learnt in providing quality homestay services to international students. It will cover social and cross-cultural issues faced by providers and international students in the homestay environment, the homestay support needs, program information, policies, procedures and code of practice governing the program.

Referral patterns and proximity to palliative care inpatient services by level of socio-economic disadvantage : a national study using spatial analysis

Background: A range of health outcomes at a population level are related to differences in levels of social disadvantage. Understanding the impact of any such differences in palliative care is important. The aim of this study was to assess, by level of socio-economic disadvantage, referral patterns to specialist palliative care and proximity to inpatient services. Methods: All inpatient and community palliative care services nationally were geocoded (using postcode) to one nationally standardised measure of socio-economic deprivation – Socio-Economic Index for Areas (SEIFA; 2006 census data). Referral to palliative care services and characteristics of referrals were described through data collected routinely at clinical encounters. Inpatient location was measured from each person’s home postcode, and stratified by socio-economic disadvantage. Results: This study covered July – December 2009 with data from 10,064 patients. People from the highest SEIFA group (least disadvantaged) were significantly less likely to be referred to a specialist palliative care service, likely to be referred closer to death and to have more episodes of inpatient care for longer time. Physical proximity of a person’s home to inpatient care showed a gradient with increasing distance by decreasing levels of socio-economic advantage. Conclusion: These data suggest that a simple relationship of low socioeconomic status and poor access to a referral-based specialty such as palliative care does not exist. Different patterns of referral and hence different patterns of care emerge.

Existential place-making : the dialogical realms of design for dwelling with disability

The world of disability is often neglected or taken for granted in able-bodied society. Apart from the challenge that disability is a social construct (Linton, 1998, 2006; Longmore, 2003; Thompson, 1997) there is an impact on the people with disability that they either feel left out or they don’t belong in the larger community. The able-bodied community is also left with very little knowledge or no sensitivity towards people with disability. These internal whirlpools do not contribute to any community only to create larger gaps and higher differences between the groups of people. Peace (2010) claims that disability is something imposed on to a person on top of a physical impairment. Nord (2008) advocates that while environmental barriers and social attitudes are crucial aspects of a person’s experience, they can indeed disable a person. The study reported high-lights what is home for people with disability and their family members. The way the person with disability and family members without disability share the same home and nurture personal relationships with each other demands greater attention. This research sheds light on the intricate relationships that exists between the family members including person with disability and their built environment. These existential connections provide a holistic viewpoint and the glimpse into the lived experiences of homes for people with disability and their care-givers. Concepts of universal design or barrier free design have not been successful (Connell and Sanford, 1999) in revealing in-depth the nature of place-making for people with disability and their care-givers. Such studies fail to incorporate the holistic needs of individuals with disability and their family members in terms of their bodily, visceral, emotional, social, psycho-social, intuitive, spiritual and temporal needs, to name a few (Franz, Bitner, 2010). This paper reports on some preliminary findings on phenomena of dwelling for people with different kinds of disability and their care-givers sharing the same home from an interior design perspective.