Discharge planning: from the acute sector for people over the age of 65

This paper reports the findings relating to discharge planning from a larger study (Hegney et al 2001) that aimed to investigate options to improve care co-ordination between the aged, community, acute and primary care sectors for the elderly residents of a large provincial town. The data, which were collected from a wide variety of aged care stakeholders in the region, are consistent with previous Australian studies. First, it appears that inappropriate discharge from acute hospitals occurs in Toowoomba because there is a perceived lack of information regarding the available community care options and a lack of suitable models to support people's care needs within their own homes. Second, inappropriate discharge practices from acute hospitals occur due to a lack of knowledge and communication on the part of health professionals employed in these settings with regard to the on- going health care needs of elderly people. Third, there is little discharge planning occurring that includes the general practitioner in post-discharge care. Finally, inappropriate discharge can also be attributed to the lack of sub-acute/step-down/rehabilitation options and long waiting lists for community home care services in the region.

The interface of acute and aged care: the role of the nurse in provincial area

Objective: This study was to investigate issues that arose from pre-admission to post-discharge, for people in Toowoomba, Queensland over the age of 65 admitted to an acute facility. This paper concentrates on a significant concern that emerged from the latge amount of data collected during this project, that is, the role of the nurse in the continuum of health care involving elderly people.

Method: The study involved a multi-site, multi-agency and multi-method (qualitative and quantitative) approach. Data was collected from regional service providers, the Department of Health and Aged Care (DHAC), the Australian Bureau of Statistics (ABS), Home and Community Care (HACC), the Aged Care Assessment Team (ACAT), elderly people who had been discharged from regional hospitals and their carers, residents of regional aged care facilities, area health professionals and elderly regional hospital inpatients.

Results: The data indicated that nurses in this provincial area currently play a limited role in preadmission planning, being mostly concerned with elective surgery, especially joint replacements. While nurses deliver the majority of care during hospitalisation, they do not appear to be cognizant of the needs of the elderly regarding post-acute discharge.

Conclusion: The recent introduction of the model of nurse case management in the acute sector appears to be a positive development that will streamline and optimise the health care of the elderly across the continuum in the Toowoomba area. The paper recommends some strategies, such as discharge liaison nurses based in Emergency Departments and the expansion of the nurse case management role, which would optimise care for the elderly person at the interface of care.

In the realm of the hackers

In the late 1980s, Melbourne was the hub of the computer underground in Australia, if not the world. The hackers who formed the underground were not disgruntled computer professionals or gangs of organised criminals. They were disaffected teenagers who used their basic home computers to explore the embryonic Internet from inside their locked, suburban bedrooms. From this shadowy world emerged two elite hackers known as Electron and Phoenix, who formed part of an alliance called The Realm. In the Realm of the Hackers charts Electron's journey from his initial innocent explorations to his ultimate obsession. It vividly recreates the climate of the 1980s, before there was public access to the Internet. The program takes us headlong into the clandestine, risky but intoxicating world of the computer underground to uncover not only how the hackers did it but why.

Karachi violence putting NATO troops in Afghanistan at risk

There is a threat to Nato forces in Afghanistan which the world is ignoring. Violent gangs have been killing indiscriminately in Karachi, the Pakistani city vital to the supply chain which sustains ISAF forces in their fight against the Taliban.

Bloods, Crips and Southern Cross Soldiers: we are all gangbangers now!

This paper presents findings from the author's PhD thesis exploring violent youth subcultures in Australia. It addresses whether growing uncertainties around issues of cultural identity and belonging in an era of risk has produced more defensive models of DIY youth culture at a local scale. Theoretically, the author examines whether globalisation has unsettled normative youth subject positions associated with the nation-state, problematising conventional logics of youth cultural formation (i.e. which view questions of race and racism through a white/black, mainstream/subculture binary). As Beck (1992;1999) argues, the de-bounding influence of globalisation has led to an ambivalent set of relations where forms of youth identity have become freed from the nation-state and class based forms of community and must be self-organised. In particular, he argues that this has produced cosmopolitan subjects and social movements as well as ‘counter-modern’ subjects and cultures. This paper applies Beck’s theories alongside theories focused on global/local influences on youth culture to an ethnographic study of two violent youth subcultures in Australia, these being the white ‘patriotic’ youth formation which emerged in the Cronulla riots and youth gang formations in Melbourne’s western suburbs. In doing so the author examines the extent to which violent youth subcultures in Australia can be regarded as strategic responses intended to restore forms of collective cultural belonging at a local scale vis a vis ‘the global’ and its destabilizing influences.