Cash, customers, and care: The experience and meaning of differential payment for high care places in aged care facilities

The introduction of new asset/income tested charges for high care residents was the 1997-98 Commonwealth government policy response to concerns about financing residential aged care. This in-depth study of residents, families, staff and managers in three aged care facilities explores issues of equity, access and empowerment arising when some residents pay more for the same level of care and amenity. The study reports little evidence of financial contributions affecting access to high care places and the delivery of care, the potential for differential access to amenities such as single rooms linked to the extra payments, and no evidence of a sense of empowerment linked to payment of the new charges. The complexity of current financial arrangements, access to appropriate financial advice at the time of entry, and the potential for an informal two tier system in relation to the allocation Of amenities are identified as developing policy issues.

Heat transfer and flow behind a step in high enthalpy superorbital flow

Heat transfer levels have been investigated behind a rearward-facing step in a superorbital expansion tube. The heat transfer was measured along a flat plate and behind 2 and 3mm steps with the same length to step height ratio. Results were obtained with air as the test gas at speeds of 6.76kms(-1) and 9-60kms(-1) corresponding to stagnation enthalpies of 26MJ/kg and 48MJ/kg respectively. A laminar boundary layer was established on the flat plate and measured heat transfer levels were consistent with classical empirical correlations. In the case of flow behind a step, the measurements showed a gradual rise in heat transfer from the rear of the step to a plateau several step heights downstream for both flow conditions. Reattachment distance was estimated to be approximately 1.6 step heights downstream of the 2mm step at the low enthalpy condition through the use of flow visualisation.

Displaying the future: Techno-nationalism and the rise of the consumer in postwar Japan

This paper explains how, in the aftermath of World War II, a type of techno-nationalism emerged that linked being Japanese to science and technology and the increased consumption of electrical appliances. By closely examining official exhibitions, we can see how the state and private sector strongly encouraged this techno-scientific dreaming. Dazzling displays highlighted how the peaceful atom would help lead the nation to achieve high economic growth. At the same time, through the judicious purchase of labor saving appliances, consumers could reconcile the need to spend with the need to save.

Preliminary experience of allied health assessments delivered face to face and by videoconference to a residential facility for elderly people

We investigated whether allied health assessments carried out via videoconferencing were comparable to assessments carried out face to face. Five allied health therapists (in dietetics, occupational therapy, physiotherapy, podiatry and speech pathology) conducted an assessment of 12 high-dependency residents both face to face and by videoconferencing. On a five-point Likert scale, the therapists' mean ratings for the efficiency and suitability of videoconferencing for assessment were significantly lower than for face to face. Their mean rating for the adequacy of their care plans was also significantly lower for videoconferencing than for face to face. However, in each case the dietician's assessments did not differ significantly between the two modalities. In 35 cases out of 60, two independent raters agreed that the therapists' care plans after the videoconferencing and face-to-face assessments were the same. However, the level of agreement between raters was only moderate (kappa=0.31). Despite the therapists' (natural) preference for face-to-face working, care plans formulated via videoconferencing were reasonably similar to those formulated in face-to-face assessment. Allied health assessments carried out by videoconferencing would therefore seem to be feasible.

The cost of allied health assessments delivered by videoconference to a residential facility for elderly people

We calculated the cost of providing allied health assessments to high-dependency residents of a rural facility for elderly people. The costs of conducting assessments via videoconferencing were compared with the costs of conducting assessments face to face. The observed costs in a three-month pilot trial were used to estimate the annual costs. Given an annual workload of 1000 occasions of service, each videoconference assessment would cost $84.93, compared with $90.25 for face-to-face assessments. Allied health assessments delivered by videoconferencing became cheaper at workloads of approximately 850 occasions of service annually. Additional increases in the workload further improved the financial viability of this approach to service delivery.

Numerical modelling of thermal effects in rats due to high-field magnetic resonance imaging (0.5-1 GHz)

A finite-difference time-domain (FDTD) thermal model has been developed to compute the temperature elevation in the Sprague Dawley rat due to electromagnetic energy deposition in high-field magnetic resonance imaging (MRI). The field strengths examined ranged from 11.75-23.5 T (corresponding to H-1 resonances of 0.5-1 GHz) and an N-stub birdcage resonator was used to both transmit radio-frequency energy and receive the MRI signals. With an in-plane resolution of 1.95 mm, the inhomogeneous rat phantom forms a segmented model of 12 different tissue types, each having its electrical and thermal parameters assigned. The steady-state temperature distribution was calculated using a Pennes 'bioheat' approach. The numerical algorithm used to calculate the induced temperature distribution has been successfully validated against analytical solutions in the form of simplified spherical models with electrical and thermal properties of rat muscle. As well as assisting with the design of MRI experiments and apparatus, the numerical procedures developed in this study could help in future research and design of tumour-treating hyperthermia applicators to be used on rats in vivo.

Perceived environment attributes, residential location, and walking for particular purposes

Background: Identifying environmental factors that can influence physical activity is a public health priority. We examined associations of perceived environmental attributes with walking for four different purposes: general neighborhood walking, walking for exercise, walking for pleasure, and walking to get to and from places. Methods: Participants (n =399; 57% women) were surveyed by mail. They reported place of residence, walking behaviors, and perceptions of neighborhood environmental attributes. Results: Men with the most positive perceptions of neighborhood aesthetics were significantly more likely (odds ratio [OR] =7.4) to be in the highest category of neighborhood walking. Men who perceived the weather as not inhibiting their walking were much more likely (OR= 4.7) to be high exercise walkers. Women who perceived the weather as not inhibiting their walking were significantly more likely to be high neighborhood walkers (OR=3.8) and those with moderate perceptions of accessibility were much more likely to do more walking for pleasure (OR=3.5). Conclusions: Different environmental attributes were associated with different types of walking and these differed between men and women. Approaches to increasing physical activity might usefully focus on those attributes of the local environment that might influence particular subsets of walking behavior.

Improved physical performance in older adults undertaking a short-term programme of high-velocity resistance training

Background: The age-related loss of muscle power in older adults is greater than that of muscle strength and is associated with a decline in physical performance. Objective: To investigate the effects of a short-term high-velocity varied resistance training programme on physical performance in healthy community-dwelling adults aged 60-80 years. Methods: Subjects undertook exercise (EX; n = 15) or maintained customary activity (controls, CON; n = 10) for 8 weeks. The EX group trained 2 days/week using machine weights for three sets of eight repetitions at 35, 55, and 75% of their one-repetition maximum (the maximal weight that an individual can lift once with acceptable form) for seven upper- and lower-body exercises using explosive concentric movements. Results: Fourteen EX and 10 CON subjects completed the study. Dynamic muscle strength significantly increased (p = 0.001) in the EX group for all exercises (from 21.4 +/- 9.6 to 82.0 +/- 59.2%, mean +/- SD) following training, as did knee extension power (p < 0.01). Significant improvement occurred for the EX group in the floor rise to standing (10.4 &PLUSMN; 11.5%, p = 0.004), usual 6-metre walk (6.6 &PLUSMN; 8.2%, p = 0.010), repeated chair rise (10.4 &PLUSMN; 15.6%, p = 0.013), and lift and reach (25.6 &PLUSMN; 12.1%, p = 0.002) performance tasks but not in the CON group. Conclusions: Progressive resistance training that incorporates rapid rate-of-force development movements may be safely undertaken in healthy older adults and results in significant gains in muscle strength, muscle power, and physical performance. Such improvements could prolong functional independence and improve the quality of life. Copyright (C) 2005 S. Karger AG, Basel.

Knowledge and understanding of choice diversity of residential care staff working with individuals with intellectual disabilities

The present study aimed to trial the effectiveness of 10 newly developed brief vignettes portraying typical interactions between staff and people with intellectual disabilities in residential care settings to assess the knowledge and understanding of staff about choice diversity, pre- and post-attendance at a staff training workshop. A total of 29 residential staff completed the Vignette Rating Scale and a knowledge questionnaire pre- and post-training. A t- test conducted on the vignettes revealed that respondents identified fewer choices in the post-test vignettes compared to the pre-test vignettes. Results showed no significant difference between the pre- and post-test data on the knowledge questionnaire. The questionnaire revealed a high level of knowledge about choice prior to and following training. The vignettes, however, proved effective in measuring changes in awareness of choice diversity among residential staff following participation in a staff training workshop.

High- and low-volume resistance training similarly enhances functional performance in older adults

It is well known that resistance training improves muscle strength in older adults and may enhance or preserve functional performance. However, it is unclear if the volume of work undertaken in the elderly alters the response in functional performance. PURPOSE: To investigate the effect of a high- versus low-volume resistance training program on functional performance in older adults. METHODS: Thirty-two healthy men and women aged 65-78 years were randomly assigned to either a single-set (SS, n = 16) or 3-set (MS, n = 16) progressive resistance training program for 20 weeks. Groups trained 2 days per week using machine weights at 8 repetitions maximum (8-RM) for 7 upper and lower body exercises. Muscle strength was assessed by the 1-RM and functional performance by a battery of tests (repeated chair rise, usual and fast 6-m walk, 6-m backwards walk, floor rise to standing, stair climb, and 400-m walk time). RESULTS: Twenty-eight subjects completed the study. There was no difference between groups at baseline in muscle strength or functional performance. Whole body muscle strength significantly increased in both groups with greater gains in the 3-set group (MS 32.9 ± 3.1%; SS 18.6 ± 2.7%, mean ± SE; P < 0.01). Significant improvement (time effect, P < 0.01) occurred for both groups in the chair rise (MS 13.6 ± 3.2%; SS 10.2 ± 3.0%), 6-m backwards walk (MS 14.9 ± 3.3%; SS 14.3 ± 4.2%), stair climb (MS 6.4 ± 2.8%; SS 7.7 ± 3.1%) and 400-m walk (MS 7.4 ± 1.4%; SS 3.9 ± 1.2%). There were no interaction (group × time) effects for functional performance and no differences by sex. CONCLUSION: Resistance training that utilizes either a singleset or 3-set regimen may significantly and similarly improve functional performance in community-dwelling older adults. Enhancement of functional performance may prolong independence and improve quality of life. ©2004The American College of Sports Medicine

Future Engineers Australia Management Project: Turning high school students into engineering entrepreneurs

There has been a strong move towards entrepreneurial education in high schools and at universities over the past few years. This has been echoed by a call from state governments around Australia to promote enterprise thinking and education in high schools. It also parallels the push within engineering to learn across the traditional boundaries , particularly between engineering and business. To meet this call, The Engineering Link Group (TELG) developed the Future Engineers Australia Management Project (FEAMP) in 2003. The project is based around Enterprise Education, and was inspired by the Smallpeice Year 12 Engineering Management course in the UK. The idea was to take high school students in years 11 and 12 and turn them into ‘engineering entrepreneurs’. This paper presents the design, development and evaluation of FEAMP as a five day residential course for year 11 and 12 students who want to learn more about being entrepreneurs and managers. It is a hands-on activity where the students invent, develop and sell an engineering concept to venture capitalists and ultimately to customers at a trade fair. It has been run successfully for two years, going from strength to strength. © 2005, Australasian Association for Engineering Education