Cleaning, resistant bacteria, and antibiotic prescribing in residential aged care facilities

Residents of residential aged care facilities (RACFs) are at risk of colonization and infection with multidrug-resistant bacteria, and antibiotic prescribing is often inappropriate and not based on culture-proven infection. We describe low levels of resident colonization and environmental contamination with resistant gram-negative bacteria in RACFs, but high levels of empirical antibiotic use not guided by microbiologic culture. This research highlights the importance of antimicrobial stewardship and environmental cleaning in aged care facilities.

Human residential status and habitat quality affect the likelihood but not the success of lapwing breeding in an urban matrix

Wildlife living in the suburbs faces the challenge of dealing with human presence and yard management (including the occurrence of pets) which vary at the scale of the house block. This study examined the influence of ecological factors (e.g. extent of grass and food availability) and anthropogenic factors (e.g. human activity and garden usage) on breeding site choice and reproductive success of the ground-nesting masked lapwing Vanellus miles on Phillip Island, Australia. Lapwings nested less frequently in residential properties (high levels of human usage) compared with vacant blocks and holiday houses. They were also more likely to breed on properties with high food availability and larger areas of grass. None of these variables influenced clutch size or the probability of eggs hatching, although larger clutches and higher hatching rates tended to be associated with more food. This study shows that, for an urban exploiting species, habitat quality is not homogenous at the scale of the house block, and that human activity is avoided by a species generally considered highly tolerant of people.

Quality continence care in residential aged care facilities - what should we measure?

The article presents an abstract of a study that uses qualitative research methods to explore key stakeholder perspectives on quality continence care in residential aged care facilities.

Residential schools in a first-year undergraduate engineering programme

BACKGROUND OR CONTEXT: For over 20 years, Deakin University has delivered an accredited undergraduate engineering course by means of distance education. Prior to 2004, off-campus students were not required to attend classes in person on campus. The course was designed so that the off campus students were able to undertake all study and assessment tasks remotely from the university campus. Offering accredited domestic undergraduate engineering courses via distance education has been seen as an important strategy for helping to provide graduate domestically educated engineers to meet Australia’s current and future needs. From 2000 the Australian accreditation management system for professional engineers, as managed by Engineers Australia, has increased its scrutiny of accredited domestic undergraduate engineering courses that were provided in distance-education mode. This led to a series of policies and recommendations for Australian universities that offer accredited engineering courses in distance-education mode: one of the recommendations was that off campus
enrolled engineering students should periodically attend some campus-based activities throughout the course. During the 2004 accreditation review of engineering courses at Deakin University, the
accreditation panel requested that mandatory campus-based activities be incorporated into the accredited undergraduate engineering course. Specifically the request was that Deakin mandate that all off-campus students enrolled in an accredited undergraduate engineering course provided by university attend in person a residential school at least once during every year of equivalent full-time study load. The accreditation panel suggested a program model for the residential school component of the course as developed by the University of Southern Queensland.
PURPOSE OR GOAL: This paper describes the development of the mandatory residential school component of accredited distance education undergraduate engineering courses at Deakin University with
a particular focus on how the residential school program is implemented at level 1 (first-year full-time equivalent level) of the courses.
APPROACH: To be compliant with accreditation requirements, since 2005 Deakin has conducted residential schools for off-campus students at its Geelong Waurn Ponds Campus. Initially the schools were conducted annually over two-weeks during the first semester, and have transitioned to the current mode where the residential school is conducted as a one week programme in each of the trimesters. During these schools, activities are organised around the respective engineering-course units undertaken by students during the trimester.
DISCUSSION: The minimum requirements for the on-campus components of distance-education-mode accredited engineering courses were developed by Engineers Australia in consultation with members of the Washington Accord (International Education Alliance) and at the time of development, generated considerable debate (Palmer, 2005, 2008). The intended purpose of residential schools was for off-campus enrolled students to have reasonable exposure to a typical “on-the-campus” student experience periodically throughout the course. Elements considered suitable and worthwhile for inclusion in residential school programs included:
• in person engagement with their academic lecturers,
• presentations and interaction with guest speakers from industry,
• industry-based site visits,
• engagement in sole and group-based learning and assessment activities on campus, and
• social interaction with other students.
RECOMMENDATIONS/IMPLICATIONS/CONCLUSION: We have found that advantages to the students who attends a residential school include completing real practical work without the need to assemble their own materials at home, and social engagement with staff and students. Off-campus students leave the residential school with a sense of belonging to a “community”, “one of many doing the same and not the only one”. They have the opportunity to share their often significant professional experience with the generally younger and less experienced on-campus student colleagues. Through this interaction between on-campus and off-campus students, the on-campus students benefit as much as the off-campus students. The disadvantages to the off-campus students is the requirement to travel to Geelong for an extended time, which costs the students both money and time away from work and family. From our experience, we recommend to other institutions starting residential schools of their own that they exploit the mandatory on-campus-presence requirement to enhance learning outcomes, well publicised timetables be available to students before trimester begins (certainly before census date), a standardised academic week during trimester be set for all residential schools, encourage student feedback on the program, and apply a practice of uniformity and consistency in how the programme is managed, especially mandated student attendance. Our residential schools for off-campus-mode students have been running for over 10 years. We have found that the educational and social advantages to the student outweigh the disadvantages.

Cost-analysis of teledentistry in residential aged care facilities

INTRODUCTION: The purpose of this research was to conduct a cost-analysis, from a public healthcare perspective, comparing the cost and benefits of face-to-face patient examination assessments conducted by a dentist at a residential aged care facility (RACF) situated in rural areas of the Australian state of Victoria, with two teledentistry approaches utilizing virtual oral examination.

METHODS: The costs associated with implementing and operating the teledentistry approach were identified and measured using 2014 prices in Australian dollars. Costs were measured as direct intervention costs and programme costs. A population of 100 RACF residents was used as a basis to estimate the cost of oral examination and treatment plan development for the traditional face-to-face model vs. two teledentistry models: an asynchronous review and treatment plan preparation; and real-time communication with a remotely located oral health professional.

RESULTS: It was estimated that if 100 residents received an asynchronous oral health assessment and treatment plan, the net cost from a healthcare perspective would be AU$32.35 (AU$27.19-AU$38.49) per resident. The total cost of the conventional face-to-face examinations by a dentist would be AU$36.59 ($30.67-AU$42.98) per resident using realistic assumptions. Meanwhile, the total cost of real-time remote oral examination would be AU$41.28 (AU$34.30-AU$48.87) per resident.

DISCUSSION: Teledental asynchronous patient assessments were the lowest cost service model. Access to oral health professionals is generally low in RACFs; however, the real-time consultation could potentially achieve better outcomes due to two-way communication between the nurse and a remote oral health professional via health promotion/disease prevention delivered in conjunction with the oral examination.

Survey of infection control and antimicrobial stewardship practices in Australian residential aged-care facilities

This study assessed infection prevention and antimicrobial stewardship (AMS) practices in Australian residential aged-care facilities (RACF). Two hundred and sixty-five surveys (15.6%) were completed with all states represented and the majority (177 (67.3%)) privately run. Only 30.6% RACF had infection control trained staff on site. Few facilities had AMS policies, only 14% had antimicrobial prescribing restrictions. Most facilities offered vaccination to residents (influenza vaccination rates >75% in 73% of facilities), but pneumococcal vaccination was poor.

Wireless video-based sensor networks for surveillance of residential districts

Compared to traditional wired video sensor networks to supervise a residential district, Wireless Video-based Sensor Networks (WVSN) can provide more detail and precise information while reduce the cost. However, state-of-the-art low cost wireless video-based sensors have very constrained resources such as low bandwidth, small storage, limited processing capability, and limited energy resource. Also, due to the special sensing range of video-based sensors, cluster-based routing is not as effective as it apply to traditional sensor networks. This paper provides a novel real-time change mining algorithm based on an extracted profile model of moving objects learnt from frog's eyes. Example analysis shows the extracted profile would not miss any important semantic images to send to the Base Station for further hazards detection, while efficiently reducing futile video stream data to the degree that nowadays wireless video sensor can realize. Thus it makes WVSN available to surveillance of residential districts.

Analysis of different scenarios for residential energy management under existing retail market structure

This paper presents an analysis of a residential energy management scheme under existing retail market structure with the integration of solar photovoltaic (PV) and battery energy storage systems. In this paper, different scenarios are analyzed with an aim of achieving the most cost-effective solutions for the integration of solar PV and battery energy storage systems. The main idea behind these analyses is to obtain a grid independent residential energy management system through the reduction of purchasing energy from the existing power grid. The results from the analysis of different scenarios for a typical Australian house demonstrate that the shortage of energy during the high loads and excess of energy during the higher output of solar PV system can be reduced with the design of a proper energy management scheme employing a transactive energy management framework.

The impact of occupant behaviour on residential greenhouse gas emissions reduction

In 2011-12, greenhouse gas emissions from the Australian residential sector were 101.6 Mt and are expected to grow by 38% by 2050. In order to reduce these emissions, much emphasis has been placed on increasing the energy efficiency of buildings and appliances. Occupant behaviour, however, is probably the single most significant factor which determines energy use and emissions. This paper describes research undertaken to rank the most common occupant behaviours, based upon their impact on greenhouse gas emissions associated with residential energy use, in an architect-designed house in Australia. The occupant behaviours investigated were changing: the heating and cooling temperature set points, window openings, external blind use and lighting use. Simulations were carried out using Primero and EnergyPlus software. Based on the simulation results of greenhouse gas emissions, the following ranking of overall influence (from most influential to the least) has been determined: external blind use was one of the most effective measures to reduce emissions. Cooling set point temperature was similarly important with the magnitude of impact depending on the set point e.g. a 2°C increase had an impact comparable to the use of external blinds. The impact of the heating set point temperature was also dependent on the set point and overall slightly lower compared to the cooling set point temperature. Lighting use was the least influential parameter in the context of this study.

Freshman residential schools for undergraduate on-campus and on-line engineering students

By means of evidence-based practice, this paper describes the residential-school component of an accredited online (distance education) undergraduate engineering program in Australia, with a particular focus on how the residential school program is implemented at freshman year. During these residential schools, activities were organised around the respective engineering courses undertaken by students during the semester. Elements considered suitable and worthwhile for inclusion in residential-school programs included: • In-person engagement with academic lecturers, • Practical and laboratory learning activities, • Presentations and interaction with guest speakers from industry, • Industry-based site visits, • Engagement in sole and group-based learning and assessment activities on campus, and • Social interaction with other students. After running pilot residential schools for two years, it was found that a workable format consisted in a two-week residential experience in the first semester, linked to two key freshman courses, Fundamentals of Technology Management, and Engineering Physics. On-campus and online students’ academic grades were compared for both courses over the years 2005 to 2012. We found that for physics lab, on-campus students’ grades tended to be higher than those for online students, and vice versa for technology management. We also conclude that when carefully designed, residential schools for online students do enhance learning for both online students and their on-campus counterparts.

Assessing pain in older people in residential aged care facilities

The recognition of pain in older people can be complicated by thepresence of dementia and misconceptions that pain is a part ofageing. Older people in residential aged care facilities should beassessed regularly for the presence of pain and managed accordingly.

Backyard bandicoots : community attitudes towards conservation planning in residential developments

As global populations grow, cities are stretching their urban boundaries into rural areas and bringing the challenges of biodiversity conservation into the backyards of homeowners. Planning controls can attempt to regulate residents’ behaviours to support conservation actions for threatened species but need to consider whether community attitudes align with conservation objectives. This study investigated community attitudes towards planned management interventions in a new conservation strategy designed to protect endangered Southern Brown Bandicoots in new residential estates around Cranbourne, Australia. A survey (n = 318, response rate 15.2 per cent) investigated current resident attitudes towards bandicoot conservation, cat ownership and effectiveness of current planning controls. Results indicate community support for a range of bandicoot conservation actions including confinement of domestic cats and non-lethal cat controls and for new developments being cat-free with bandicoot habitat corridors. Awareness of bandicoots correlated with higher support for conservation actions while cat owners were less supportive overall, particularly to limitations on cat ownership. Potential barriers to management interventions include inadequate knowledge, perceived associated risks and housing turnover. This information is valuable for conservation planning for new developments and to improve implementation of planning controls in existing residential areas for delivery of long-term protection for threatened species like Southern Brown Bandicoots.

A Generalized hierarchical transactive energy management framework for residential microgrids

This work develops a transactive energy management system in order to automate the operation and efficiently utilize the energy generated from the solar PV unit and BESS in a single house as well as in the microgrid and provides cost-benefit analysis.