Training AAC users in user-centred design

User-centred design (UCD) with a focus on usability provides product developers with a design approach in which users are involved in every stage of the process: when gathering requirements; when evaluating alternative designs; and when evaluating interactive prototypes.The characteristics of people who use augmentative and alternative communication (AAC) make it difficult to follow a truly UCD approach, which in part may contribute to the high rejection of AAC devices. Training workshops have been delivered to introduce users and AAC professionals to the UCD process.Initial feedback indicates that they feel more empowered to evaluate systems and to engage in the design of new systems after attending the workshop.

Comparing subjective well-being and health-related quality of life of Australian drug users in treatment in regional and rural Victoria

The aim of this study is to examine the self-reported subjective well-being and health-related quality of life (HRQOL) of alcohol and other drug users and to examine whether subjective well-being in this sample would be predicted by either HRQOL and/or severity of dependence.

Advance care planning for older people in Australia presenting to the emergency department from the community or residential aged care facilities

The purpose of this retrospective, cross-sectional study was to determine the prevalence of advance care planning (ACP) among older people presenting to an Emergency Department (ED) from the community or a residential aged care facility. The study sample comprised 300 older people (aged 65+ years) presenting to three Victorian EDs in 2011. A total of 150 patients transferred from residential aged care to ED were randomly selected and then matched to 150 people who lived in the community and attended the ED by age, gender, reason for ED attendance and triage category on arrival. Overall prevalence of ACP was 13.3% (n = 40/300); over one-quarter (26.6%, n = 40/150) of those presenting to the ED from residential aged care had a documented Advance Care Plan, compared to none (0%, n = 0/150) of the people from the community. There were no significant differences in the median ED length of stay, number of investigations and interventions undertaken in ED, time seen by a doctor or rate of hospital admission for those with an Advance Care Plan compared to those without. Those with a comorbidity of cerebrovascular disease or dementia and those assessed with impaired brain function were more likely to have a documented Advance Care Plan on arrival at ED. Length of hospital stay was shorter for those with an Advance Care Plan [median (IQR) = 3 days (2–6) vs. 6 days (2–10), P = 0.027] and readmission lower (0% vs. 13.7%). In conclusion, older people from the community transferred to ED were unlikely to have a documented Advance Care Plan. Those from residential aged care who were cognitively impaired more frequently had an Advance Care Plan. In the ED, decisions of care did not appear to be influenced by the presence or absence of Advance Care Plans, but length of hospital admission was shorter for those with an Advance Care Plan.

Ethical challenges associated with providing continence care in residential aged care facilities : findings from a grounded theory study

A person-centred approach to care in residential aged care facilities should uphold residents’ rights to independence, choice, decision-making, participation, and control over their lifestyle. Little is known about how nurses and personal care assistants working in these facilities uphold these ideals when assisting residents maintain continence and manage incontinence. The overall aim of the study was to develop a grounded theory to describe and explain how Australian residents of aged care facilities have their continence care needs determined, delivered and communicated. This paper presents and discusses a subset of the findings about the ethical challenges nurses and personal care assistants encountered whilst providing continence care. Grounded theory methodology was used for in-depth interviews with 18 nurses and personal care assistants who had experience of providing, supervising or assessing continence care in any Australian residential aged care facility, and to analyse 88 hours of field observations in two facilities. Data generation and analysis occurred simultaneously using open coding, theoretical coding, and selective coding, until data were saturated. While addressing the day-to-day needs of residents who needed help to maintain continence and/or manage incontinence, nurses and personal care assistants struggled to enable residents to exercise choice and autonomy. The main factor that contributed to this problem was that the fact that nurses and personal care assistants had to respond to multiple, competing, and conflicting expectations about residents’ care needs. This situation was compounded by workforce constraints, inadequate information about residents’ care needs, and an unpredictable work environment. Providing continence care accentuated the ethical tensions associated with caregiving. Nurses’ and personal care assistants’ responses were mainly characterised by highly protective behaviours towards residents. Underlying structural factors that hinder high quality continence care to residents of aged care facilities should be urgently addressed.

Portfolio delivery approach to township sewage treatment facilities in China: a case study

 The wide need for sewage treatment facilities at the township level across China implies an emerging niche market for water and sanitation developers, investors and financiers. However this potential market is difficult to enter with traditional financing and delivery methods, because township sewage features small amount, volatile quantity, geographically scattering, immature fee charging system, weak affordability, and lack of capacities. A group of concession sewage treatment projects collectively implemented by a private company in the Changsha County of Hunan Province under the so called ‘Changsha Model’ provided innovative solutions. This cases study first examined the portfolio approach in terms of multiple delivery method integration, technology, and centralized control system, and evaluated the replicability of the new model. Practices and lessons learned from the case were then presented and summarized that can be applied to the following township sewage treatment facility development. Last, the Changsha Model was compared with similar infrastructure portfolio delivery solutions applied in the US.

Are the popular users always important for information dissemination in online social networks?

This article verifies the importance of popular users in OSNs. The results are counter-intuitive. First, for dissemination speed, a large amount of users can swiftly distribute information to the masses, but they are not highly-connected users. Second, for dissemination scale, many powerful forwarders in OSNs cannot be identified by the degree measure. Furthermore, to control dissemination, popular users cannot capture most bridges of social communities.