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.

Close, but still too far: the experience of Australian people with cancer commuting from a regional to a capital city for radiotherapy treatment

This paper reports the findings of a study undertaken in November 2001 on the experiences of 17 rural people from the regional city of Toowoomba who had been diagnosed with cancer and were required to travel to the capital city of Queensland (Brisbane) for radiotherapy. The interviews were tape recorded; the recordings were transcribed verbatim and analysed for emergent themes and subthemes, following verification by the participants that the transcription was a true record of their experience. The major themes that arose from the study were (1) the burden of travel; (2) the difficulties of living in accommodation that is not one's own home; (3) the financial burden caused by the need to relocate or travel to and from Brisbane; (4) the lack of closeness to family and friends; (5) and feelings of being a burden on others. The findings suggest that at a time of stress, an increasing burden is placed on cancer clients and their families if they are required to travel for radiotherapy. Health professionals who read the results of this study should be aware of the isolation of rural people who have to live in an unfamiliar environment at a time of great stress. Support mechanisms should be put into place in these referral centres to deal with these stressors.

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.

The rural medicine rotation: Increasing rural recruitment through quality undergraduate rural experiences

TITLE: The Rural Medicine Rotation: Increasing Rural Recruitment through Quality Undergraduate Rural Experiences Eley Diann, University of Queensland, School of Medicine, Rural Clinical Division, Toowoomba 4350, Queensland Australia Baker Peter, University of Queensland, School of Medicine Rural, Clinical Division, Toowoomba 4350, Queensland Australia Chater Bruce, University of Queensland, Chair, Clinical School Management Committee, School of Medicine Rural Clinical Division, Queensland Australia CONTEXT: While rural background and rural exposure during medical training increases the likelihood of rural recruitment (Wilkinson, 2003), the quality and content of that exposure is the key to altering undergraduatesâ?? perceptions of rural practice. The Rural Clinical Division at University of Queensland (UQ) runs the Rural Medicine Rotation (RMR) within the School of Medicine. The RMR is one of five eight week clinical rotations in Year three and is compulsory for all students. The RMR provides the opportunity to learn from a wide range of health professionals and clinical exposure is not restricted to general practice but also includes remote area nursing, Indigenous health care, allied health professionals and medical specialists. Week 1 involves preparation for their rural placement with workshops and seminars and Week 8 consolidates their placement and includes case and project presentations and a summative assessment. Weeks 2-7 are spent living and working as part of the health team in different rural communities. SETTING: Rural communities in and around Queensland including locations such as Arnham Land, Thursday Island, Mt. Isa and Alice Springs METHOD: All aspects of the RMR are evaluated with surveys using both qualitative and quantitative free response questions, completed by all students at the end of the Week 8. RESULTS: Overall the RMR is evaluated highly and narratives offered by students show that the RMR provides a positive rural experience. The overall impact of the RMR for students in 2004 ranked 3.45 on a scale of 1 to 4 (1 = lowest and 4 = highest), and is exemplified by the following quote; â??I enjoyed my placement so much I am now considering rural medicine something I definitely had not considered beforeâ??. OUTCOME: The positive impact of the RMR on studentâ??s perceptions of rural medicine is encouraging and can help achieve the overall aim of increasing recruitment of the rural workforce in Australia.

Winter sowing for more reliable boll filling in Central Queensland

The Central Highlands region has a unique climate that presents both challenges and novel farming systems opportunities for cotton production. We have been re-examining the Emerald climate in a bid to identify opportunities that might enable the production of more consistent cotton yields and quality in what can be a highly variable climate. A detailed climatic analysis identified that spring and early summer is the most optimal period for boll growth and maturation. However, to unlock this potential requires unseasonal winter sowing that is 4 to 6 weeks earlier than the traditional mid-September sowing. Our experiments have sought answers to two questions: i) how much earlier can cotton be sown for reliable crop establishment and high yield; ii) can degradable plastic film mulches minimise the impact of potentially cold temperatures on crop establishment and early vigour. Initial data suggests August sowing offers the potential to grow a high yield at a time of year with reduced risk of cloud and high night temperatures during boll growth. For the past two seasons late winter sowing (with and without film) has resulted in a compact plant with high retention that physiologically matures by the beginning of January. Even with the spectre of replanting cotton in some seasons due to frost in August, early sowing would appear to offer the opportunity for more efficient crop input usage, simplified agronomic management and new crop rotation options during late summer and autumn. This talk will present an overview of results to date.

What influences fungal communities in cotton soils

Soilborne diseases such as Fusarium wilt, Black root rot and Verticillium wilt have significant impact on cotton production. Fungi are an important component of soil biota with capacity to affect pathogen inoculum levels and their disease causing potential. Very little is known about the soil fungal community structure and management effects in Australian cotton soils. We analysed surface soils from ongoing field experiments monitoring cotton performance and disease incidence in three cotton growing regions, collected prior to 2013 planting, for the genetic diversity and abundance as influenced by soil type, environment and management practices and link it with disease incidence and suppression. Results from the 28S LSU rRNA sequencing based analysis indicated a total of 370 fungal genera in all the cotton soils and the top 25 genera in abundance accounted for the major portion of total fungal community. There were significant differences in the composition and genetic diversity of soil fungi between the different field sites from the three cotton growing regions. Results for diversity indices showed significantly greater diversity in the long-term crop rotation experiment at Narrabri (F6E) and experiments at Cowan and Goondiwindi compared to the Biofumigation and D1 field experiments at ACRI, Narrabri. Diversity was lowest in the soils under brassica crop rotation in Biofumigation experiment. Overall, the diversity and abundance of soil fungal community varied significantly in the three cotton growing regions indicating soil type and environmental effects. These results suggest that changes in soil fungal community may play a notable role in soilborne disease incidence in cotton.

Silverleaf whitefly resistance management

Silverleaf whitefly (SLW) is a major late season pest of cotton due to its potential to contaminate cotton lint with honeydew. To prevent this, management is often reliant on the use of insecticides to control SLW populations. With selection pressure SLW develop resistance to insecticides they are exposed to, resulting in spray failures. Our lab tests resistance levels in SLW populations collected from across the cotton industry. In this presentation I will provide an update of emerging SLW resistance issues the cotton industry is facing.

Growth and development of three key summer grasses in Australian cotton systems

Awnless barnyard grass, feathertop Rhodes grass, and windmill grass are important weeds in Australian cotton systems. In October 2014, an experiment was established to investigate the phenological plasticity of these species. Seed of these species were planted in a glasshouse every four weeks and each cohort grown for 6 months. A developmental response to day length was observed in barnyard grass but not in the other species. Days to maturity increased with each planting for feathertop Rhodes and windmill grass for the first six cohorts. Barnyard grass showed a similar pattern in growth for seeds planted from October to December with an increase in the onset of maturity from 51 to 58 days. However, the onset of maturity for cohorts planted between January and March decreased to between 50 and 52 days. All species had a decrease in the total number of panicles produced from the first four plantings. Feathertop Rhodes grass planted in October produced 41 panicles compared to those planted at the end of December producing 30 panicles, barnyard grass had a decrease from 99 to 47 panicles and windmill grass 37 to 15 panicles on average. By comparing the development of these key weed species over 12 months, detailed information on the phenological plasticity of these species will be obtained. This information will contribute to more informed management decisions by improving our understanding of appropriate weed control timings or herbicide rates depending on weed emergence and development.

Is Australia ready for triple gene herbicide stack technology?

Integration of multiple herbicide-resistant genes (trait stacking) into crop plants would allow over the top application of herbicides that are otherwise fatal to crops. The US has just approved Bollgard II® XtendFlex™ cotton which has dicamba, glyphosate and glufosinate resistance traits stacked. The pace of glyphosate resistance evolution is expected to be slowed by this technology. In addition, over the top application of two more herbicides may help to manage hard to kill weeds in cotton such as flax leaf fleabane and milk thistle. However, there are some issues that need to be considered prior to the adoption of this technology. Wherever herbicide tolerant technology is adopted, volunteer crops can emerge as a weed problem, as can herbicide resistant weeds. For cotton, seed movement is the most likely way for resistant traits to move around. Management of multiple stack volunteers may add additional complexity to volunteer management in cotton fields and along roadsides. This paper attempts to evaluate the pros and cons of trait stacking technology by analysing the available literature in other crop growing regions across the world. The efficacy of dicamba and glufosinate on common weeds of the Australian cotton system, herbicide resistance evolution, synergy and antagonisms due to herbicide mixtures, drift hazards and the evolution of herbicide resistance to glyphosate, glufosinate and dicamba were analysed based on the available literature.

CottonInfo Extending Research

There are many ways in which research messages and findings can be extended to the expansive cotton community. As everyone learns differently it is crucial that information is delivered in a variety of ways to meet the various learning needs of the CottonInfo team’s broad audience. In addition different cotton production areas often require targeted information to address specific challenges. Successful implementation of innovative research outcomes typically relies on a history of cultivated communication between the researcher and the end-user, the grower. The CottonInfo team, supported by a joint venture between Cotton Seed Distributors, Cotton Research Development Corporation, Cotton Australia and other collaborative partners, represents a unique model of extension in Australian agriculture. Industry research is extended via regionally based Regional Development Officers backed by support from Technical Specialists. The 2015 Cotton Irrigation Technology Tour is one example of a successful CottonInfo capacity building activity. This tour took seven CRDC funded irrigation-specific researchers to Emerald, Moree and Nevertire to showcase their research and technologies. These events provided irrigators and consultants with the opportunity to hear first-hand from researchers about their technologies and how they could be applied onfarm. This tour was an example of how the CottonInfo team can connect growers and researchers, not only to provide an avenue for growers to learn about the latest irrigation research, but for researchers to receive feedback about their current and future irrigation research.