The impact of the quality of behaviour support plans on the use of restraint and seclusion in disability services

Background: Behaviour support plan (BSP) quality is known to be an important aspect of the support provided to people with disability who show challenging behaviours and has been found to lead to reductions in challenging behaviour. Preliminary evidence suggests that quality of plans is associated with reductions in the use of restraint
and seclusion.
Method and materials: Quality of a sample of behaviour support plans was assessed using the Behaviour Support Plan – Quality Evaluation II (BSP-QE II) Guide (Browning Wright, Saren & Mayer, 2003). Episodes of restraint and seclusion before and during implementation of plans were examined by comparing restraint and seclusion use between individuals with high quality versus low quality plans.
Results: Compared to individuals with low quality plans, individuals with high quality plans were found to be subjected to less restraint and seclusion over time, while those with low quality plans were subjected to increases. With the exception of one quality component, all components in high quality plans were found to be associated with decreases in restraint and seclusion use.
Conclusions: The results support earlier preliminary findings that quality of behaviour support plans are associated with reductions in restrictive intervention use. The findings are important because they suggest that increasing quality of behaviour support plans may lead to decreases in restraint and seclusion over time.

The association between use of antidepressants and bone quality using quantitative heel ultrasound.

Osteoporosis and depression are major public health problems worldwide. Studies have reported an association between antidepressant use, mainly selective serotonin reuptake inhibitors (SSRIs), and bone mineral density (BMD), but the issue remains unclear.

Use of airflow to improve the nanofibrous structure and quality of nanofibers from needleless electrospinning

Mass production of nanofibers from needleless electrospinning shows great potential in research and development of nanofibers. However, how to improve the electrospinning performance so as to achieve high quality nanofibers is still of great challenge. In this study, airflow has been applied to optimize upward needleless electrospinning from ring spinneret. Effects of airflow speed and the position of airflow on the nanofiber quality and production rate have been investigated. It has been found that thinner and more uniform nanofibers were produced when airflow was applied to needleless electrospinning system. It also improved the collected nonwoven membrane, resulting in better nanofibrous structure of the as-spun nanofibers. Application of airflow on needleless electrospinning would further benefit the development of mass production of nanofibers from needleless electrospinning.

Validation of the use of input-output data for embodied energy analysis of the Australian construction industry

This paper evaluates a recently developed hybrid method for the embodied energy analysis of the Australian construction industry. It was found that the truncation associated with process analysis can be up to 80%, whilst the use of input-output analysis alone does not always provide a perfect model for replacing process data. There is also a considerable lack in the quantity and possibly quality of process data currently available. These findings suggest that current best-practice methods are sufficiently accurate for most typical applications, but this is heavily dependant upon data quality and availability. The hybrid method evaluated can be used for the optimisation of embodied energy and for identifying opportunities for improvements in energy efficiency.

A quality indicator of Australian e-business

Organisations spend large sums of money to ensure that their electronic shopfront is as attractive, appealing and efficient as any in the real world. But what about dealing with customers? If someone has a query in the real world they would perhaps approach a sales person or telephone the organisation to obtain a response. The electronic equivalent is e-mail. Do organisations pay sufficient attention to this aspect of their electronic shopfront? The study reported here was undertaken to determine the use of e-mail within Australian organisations and, more importantly, organisations' responsiveness to e-mail
queries.

Validation of the use of Australian input-output data for building embodied energy simulation

Traditional!y, the simulation of buildings has focused 011 operational energy consumption in an attempt to determine the potential for energy savings. Whilst operational energy of Australian buildings accounts for around 20% of total energy consumption nationally, embodied energy represents 20 to 50 times the annual operational energy of 1110st Australian buildings. Lower values have been shown through a number of studies that have analysed the embodied energy of buildings and their products, however these have now shown to be incomplete in system boundary. Many of these studies have used traditional embodied energy analysis methods, such as process analysis and input-output analysis, Hybrid embodied energy analysis methods have been developed, but these need to be compared and validated. This paper reports on preliminary work on this topic. The findings so far suggest that current best-practice methods are sufficiently accurate for most typical applications, but this is heavily dependant upon data quality and availability.

Use of plastic and textile media in polishing primary treated effluent

The majority of on-site sewage management systems in Australia fail to perform to expectations. About 60% to 80% of on-site systems reportedly fail to produce acceptable effluent quality, and there is an increaed concern about the risks associated with public health and environmental pollution. In Victoria, a large proportion of septic tank installations have been reported to discharge highly polluted waste to drains and streams. Users, often considered by regulators as operators, have to bear the costs of upgrade/replacement of their old systems to meet stringent water quality guidelines. Some of the common problems include clogging of the disposal fields due to solids and organic overloading and surfacing of highly polluted effluent. Large land application area is subsequently required for irrigating the effluent and/or installation of upgraded disposal fields.
This paper investigates the effectiveness of various types of textile and plastic media, in polishing primary tank effluent, downstream from a typical two-compartment septic tank system. Results to date show that high biochemical oxygen demand removal rates are achieved from the textile and plastic media (up to 86% and 83% respectively). At these removal levels, the performance of a combined conventional septic tank system and plastic/textile filters is comparable to that of an advanced aerated wastewater treatment system. This approach, subject to further investigation, could provide a less costly upgrade.

The use of artificial biofilms to strip nutrients from an industrial smelters waste water under conditions of low temperature and high pH

The Victorian Environment Protection Authority (EPA) has identified Alcoa’s Point Henry aluminium smelter as being a major source of recognized pollutant input due to its disposal of effluent into Corio Bay. Historically, the water quality parameters that have most often exceeded Point Henry’s EPA limits have been pH and suspended solids from the smelter’s discharge points. These waste water discharges also experience high nitrogen and phosphorus concentrations which result in algal blooms that occur at the onset of warm weather. The main hypothesis of this study was that “prevention of algal blooming with the onset of warm weather by removal of nutrients during the cooler months, and continued removal thereafter, is better than curing the problems chemically”. Biofilms have been used to remove nutrients from waste waters, but not under the conditions experienced at Point Henry. The aim of this study, therefore, was to determine if significant biofilm growth would be observed on floating structures suspended in the Point Henry waste water stream during the cooler, winter months of the year. Statistically significant biofilm growth occurred on all suspended structures in all discharge ponds during the winter and early spring of 2000. The use of suspended structures, such as AquaMatTM, as an artificial substrate to attract and support periphyton and bacterial communities (biofilms), which are then able to out-compete phytoplankton communities for available nutrients, is therefore a viable option for the Point Henry smelter. However, further research on the competitive performance of biofilms in the Point Henry ponds during the summer months is required before adequate biofilm management strategies can be developed.

An examination of the limitations in investigative interviewer's use of open-ended questions

Best-practice guidelines in the area of investigative interviewing of children specify the importance of using open-ended questions. However, use of open-ended questions per se does not maximise interview outcome; open-ended questions can vary markedly in quality. The aim of this study was to identify the nature of investigative interviewers' limitations when using open-ended questions, and to compare how representative these limitations are in three distinct interview paradigms. These interview paradigms include: (a) interviews in which trained actors played the role of a 5-6-year-old child; (b) interviews where 5-6-year-old children recalled an innocuous event that was staged in their school; and (c) actual field interviews where child witnesses aged 5 to 7 years recalled an abusive event. Overall, several common problems that would restrict children's opportunity to provide elaborate and accurate narrative accounts of events were identified and described. Our identification of these problems (using a dichotomous rating scale) was found to be consistent with an independent expert, and their presence was not limited to those interviewers who used a low frequency of open-ended questions. The implications of the findings for researchers and trainers in the area of investigative interviewing of children are discussed.

Optimizing the use of shed feathers for genetic analysis

Shed feathers obtained by noninvasive genetic sampling (NGS) are a valuable source of DNA for genetic studies of birds. They can be collected across a large geographical range and facilitate research on species that would otherwise be extremely difficult to study. A limitation of this approach is uncertainty concerning the quality of the extracted DNA. Here we investigate the relationship between feather type, feather condition and DNA quality (amplification success) in order to provide a simple, cost-effective method for screening samples prior to genetic analysis. We obtained 637 shed feathers of the powerful owl ( Ninox strenua) from across its range in southeastern Australia. The extracted DNA was amplified using polymerase chain reaction for a range of markers including mitochondrial DNA, ND3 and nuclear DNA, a simple sequence repeat (Nst02) and a portion of the CHD-1 gene (P2/P8). We found that feather condition significantly influenced the amplification success of all three loci, with feathers characterized as ‘good’ having greater success. Feather type was found to be of lower importance, with good quality feathers of all types consistently producing high success for all three loci. We also found that the successful amplification of multilocus genotypes was dependant on the condition of the starting material and was highly correlated with successful amplification of the sex-linked CHD-1 locus. Samples with low DNA quality have a higher probability of amplification failure and are more likely to produce incorrect genotypes; therefore, identifying samples with high DNA quality can save substantial time and cost associated with the genetic analysis of NGS. As a result, we propose a method for screening shed feathers in order to provide a subset of samples which will have a greater probability of containing high quality DNA suitable for the amplification of multilocus genotypes.

Use of calcium, folate and vitamin D3-fortified milk for 6 months improves nutritional status but not bone mass or turnover, in a group of Australia aged care

In residential care, inadequate calcium and folate intakes and low serum vitamin D (25(OH)D) concentrations are common. We assessed whether daily provision of calcium, folate, and vitamin D3-fortified milk for 6 months improved nutritional status (serum micronutrients), bone quality (heel ultrasound), bone turnover markers (parathyroid hormone, C-terminal collagen I telopeptide, terminal propeptide of type I procollagen), and/or muscle strength and mobility in a group of Australian aged care residents. One hundred and seven residents completed the study (mean (SD) age: 79.9 (10.1) years; body weight: 68.4 (15.4) kg). The median (inter-quartile range) volume of fortified milk consumed was 160 (149) ml/day. At the end of the study, the median daily vitamin D intake increased to 10.4 (8.7) μg (P < .001), which is 70% of the adequate intake (15 μg); and calcium density (mg/MJ) was higher over the study period compared with baseline (161 ± 5 mg/MJ vs. 142 ± 4 mg/MJ, P < .001). Serum 25(OH)D concentrations increased by 23 ± 2 nmol/L (83 (107)%, P < .001), yet remained in the insufficient range (mean 45 ± 2 nmol/L). Consumption of greater than the median intake of milk (160 ml/day) (n = 54, 50%) increased serum 25(OH)D levels into the adequate range (53 ± 2 nmol/L) and reduced serum parathyroid hormone by 24% (P = .045). There was no effect on bone quality, bone turnover markers, muscle strength, or mobility. Consumption of fortified milk increased dietary vitamin D intake and raised serum 25(OH)D concentrations, but not to the level thought to reduce fracture risk. If calcium-fortified milk also was used in cooking and milk drinks, this approach could allow residents to achieve a dietary calcium intake close to recommended levels. A vitamin D supplement would be recommended to ensure adequate vitamin D status for all residents.

Use of satellite telemetry on small-bodied waterfowl in Australia

The nomadic or dispersive movements of many Australian waterfowl in response to irregular environmental cues make satellite telemetry studies the only means by which these long-distance movements can be tracked in real time. Unlike some large-bodied soaring species, attaching satellite transmitters to small-bodied waterfowl (<1 kg) is not straightforward because ducks have high wing loadings and need to maintain active flapping to stay aloft. In the present paper, we detail one harness design and attachment method that enabled us to track grey teal (Anas gracilis) for up to 879 days. In addition, we detail rates of data loss, changes in data quality over time and variation in data quality from solar-powered satellite-tags deployed on ducks in Australia and Papua New Guinea. Up to 68% of all locational fixes have a nominal accuracy of less than 1 km, and satellite-tags deployed on wild birds can provide up to 22 location fixes per day and store enough energy during the day to run continuously throughout the night.

Pharmacist assessment of adherence, risk and treatment in cardiovascular disease (PAART CVD)

Cardiovascular disease (CVD) accounts for 18% of disease burden in Australia, and 35% of deaths. Evidence- based management of CVD risk requires systematic consideration of individual risk factors and overall CVD risk, and a balanced approach to lifestyle modification, the optimal use of medicines, and medicines adherence.

This project examines a pHot model for primary prevention of CVD in community pharmacy aimed at improving quality of care. Pharmacists from ten pharmacies received training in CVD risk factor management and facilitating patient lifestyle modification.

They recruited 70 participants aged 50-74 years, taking medicines for blood pressure (BP) or cholesterol, and without diabetes or CVD, At baseline, research assistants conducted a clinical assessment of anthropometric and biomedical risk factors, and conducted interviews to examine health behaviours, medicines use and related issues. Data was analysed by a consultant pharmacist and summary reports produced, with recommendations and targets for risk reduction. These were addressed by patients and their community pharmacists over five monthly sessions. At follow up, the relative risk reduction for CVD onset over the next five years was 24%, contributed to by reductions in mean systolic BP (-7mmHg), diastolic PP (-5 mmHg), total:HDL cholesterol ratio (—0.2), waist circumference (—2cm in males, —0.7cm in females) and other risk factors.

Several key health behaviours improved, including diet quality and physical activity levels. Prevalence of non-adherence to cardiovascular medicines dropped by 1 6% to 22%.

The potential health benefits from this intervention need to be confirmed via larger, controlled clinical trials. Overall, this appears to be a feasible and potentially effective public health measure.

The use of contracting out : a case study of decision-making and organisational learning in local government

One objective of government is to provide services at least cost whilst maintaining or improving service quality. While this may be an important objective, questions are being asked whether services can be provided more efficiently and effectively by the private rather than by the government sector. The shift of service provision from the public to the private sector is known as outsourcing or contracting out. The objective in this study is to critically examine whether the contracting out of services by local government to the private sector is an efficient management practice.

The contracting out of Parks and Grounds Maintenance services for the City of Kingston in the State of Victoria, Australia, is used as an exploratory case study to identify the variables associated with management decision-making in the contracting out process. Factors relevant to the contracting out decision such as the criteria used in selecting a contractor; the evaluation of a contractor’s performance; and any subsequent changes to management practice relating to the contracting out of the services are identified and discussed.

Political forces were found to be an important consideration in the initial contracting out decision, and the selection of a contractor was influenced by the potential to avoid costs. It was also found that under-bidding and associated cost /profit constraints lead to contractors engaging in non-sustainable environmental practices which resulted in the degradation of the local government’s Parks and Gardens assets. A sustainable asset management philosophy as opposed to an avoidable costs approach now underpins the contracting out process to ensure the preservation of such assets. Further, administrative processes have been revised to make tender specifications more prescriptive, critical components of services have been brought back in-house, and management practices have been amended so that a greater degree of control is exercised over contractors’ activities.