Factors influencing PRN medication use in nursing homes

Objective: To identify determinants of PRN ( as needed) drug use in nursing homes. Decisions about the use of these medications are made expressly by nursing home staff when general medical practitioners (GPs) prescribe medications for PRN use. Method: Cross-sectional drug use data were collected during a 7-day window from 13 Australian nursing homes. Information was collected on the size, staffing-mix, number of visiting GPs, number of medication rounds, and mortality rates in each nursing home. Resident specific measures collected included age, gender, length of stay, recent hospitalisation and care needs. Main outcome measures: The number of PRN orders prescribed per resident and the number of PRN doses given per week averaged over the number of PRN medications given at all in the seven-day period. Results: Approximately 35% of medications were prescribed for PRN use. Higher PRN use was found for residents with the lower care needs, recent hospitalisation and more frequent doses of regularly scheduled medications. With increasing length of stay, PRN medication orders initially increased then declined but the number of doses given declined from admission. While some resident-specific characteristics did influence PRN drug use, the key determinant for PRN medication orders was the specific nursing home in which a resident lived. Resident age and gender were not determinants of PRN drug use. Conclusion: The determinants of PRN drug use suggest that interventions to optimize PRN medications should target the care of individual residents, prescribing and the nursing home processes and policies that govern PRN drug use.

A community-based wildlife survey: the knowledge and attitudes of residents of suburban Brisbane, with a focus on bandicoots

Within the expanding city of Brisbane in south-east Queensland, numerous fragments of native and regrowth vegetation are scattered across the largely urbanised landscape. These fragments provide refuge to a great diversity of native wildlife, and, provide residents with the opportunity to experience nature on their doorstep. To assess the diversity and abundance of this wildlife, recent changes in these parameters, and the value of wildlife and bushland fragments to residents of Brisbane, a questionnaire survey was distributed to 300 households each located adjacent to one of 38 urban bushland fragments. A total of 172 surveys (57%) were returned, producing 768 records of 83 fauna species, dominated by birds and mammals; bandicoots were widely reported from the 38 fragments. Several historical records provided evidence of recent local extinctions within fragments, highlighting the continuing declines in various species of native wildlife within Brisbane. Several human-wildlife conflicts were identified, but overall residents were tolerant of such conflicts. Bandicoots were disliked by a small minority (3%) of residents owing to the holes they dig in lawns and gardens in search of food. and their potential as vectors of ticks. Most respondents expressed ail appreciation for the presence of native wildlife (96%) and bushland fragments (97%) in their local area, emphasising the importance of incorporating human dimension values into the management of this urban biodiversity.

Roost tree characteristics determine use by the white-striped freetail bat (Tadarida australis, Chiroptera : Molossidae) in suburban subtropical Brisbane, Australia

We examined factors affecting roost tree selection by the white-striped freetail bat Tadarida australis (Chiroptera: Molossidae), a large insectivorous bat in suburban Brisbane, Australia. We compared biophysical characteristics associated with 34 roost trees and 170 control trees of similar diameter, height and tree senescence characters. Roost trees used by the white-striped freetail bat had significantly higher numbers of hollows in the trunk and branches (P < 0.003) and were more likely to contain a large trunk cavity with an internal diameter of > 30 cm (P < 0.001) than control trees. These trees also accommodated more species of hollow-using fauna (P = 0.005). When comparing roost trees with control trees of similar diameters and heights, roost trees were on average at a later stage of tree senescence (P < 0.001). None of the roost trees were found in the large forest reserves fringing the Brisbane metropolitan area despite these areas being used for foraging by the white-striped freetail bat. Although all tree locations in this study were in modified landscapes, roost trees tended to be surrounded by groups of trees and undergrowth. Roost trees provide important habitat requirements for hollow-using fauna in suburban, rural and forested environments.