"Impact of the 2003 Mid-Term Review of the Common Agricultural Policy"

qec

Evidence for the long term cost effectiveness of home care reablement programs

Background: The objectives of this study were to determine whether older individuals who participated in a reablement (restorative) program rather than immediately receiving conventional home care services had a reduced need for ongoing support and lower home care costs over the next 57 months (nearly 5 years). Materials and methods: Data linkage was used to examine retrospectively the service records of older individuals who had received a reablement service versus a conventional home care service to ascertain their use of home care services over time. Results: Individuals who had received a reablement service were less likely to use a personal care service throughout the follow-up period or any other type of home care over the next 3 years. This reduced use of home care services was associated with median cost savings per person of approximately AU $12,500 over nearly 5 years. Conclusion: The inclusion of reablement as the starting point for individuals referred for home care within Australia's reformed aged care system could increase the system's cost effectiveness and ensure that all older Australians have the opportunity to maximize their independence as they age

Emergency department transfers from residential aged care: What can we learn from secondary qualitative analysis of Australian Royal Commission data?

Objectives: To use publicly available submissions and evidence from the Australian Royal Commission into Aged Care Quality and Safety as data for secondary qualitative analysis. By investigating the topic of emergency department transfer from the perspective of residents, family members and healthcare professionals, we aimed to identify modifiable factors to reduce transfer rates and improve quality of care. Design: The Australian Royal Commission into Aged Care Quality and Safety has made over 7000 documents publicly available. We used the documents as a large data corpus from which we extracted a data set specific to our topic using keywords. The analysis focused on submissions and hearing transcripts (including exhibits). Qualitative thematic analysis was used to interrogate the text to determine what could be learnt about transfer events from a scholarly perspective. Results: Three overarching themes were identified: shortfalls and failings, reluctance and misunderstanding, and discovery and exposure. Conclusions: The results speak to workforce inadequacies that have been central to problems in the Australian aged care sector to date. We identified issues around clinical and pain assessment, lack of consideration to advance care directives and poor communication among all parties. We also highlighted the role that emergency departments play in identifying unmet clinical needs, substandard care and neglect. Given the inadequate clinical care available in some residential aged care facilities, transferring residents to a hospital emergency department may be making the best of a bad situation. If the objective of reducing unnecessary transfers to emergency departments is to be achieved, then access to appropriate clinical care is the first step

Population data centre profile - The Western Australian data linkage branch

Established in 1995, the Western Australian Data Linkage Branch (DLB) is Australia’s longest running data linkage agency. The Western Australian Data Linkage System (WADLS) employs an enduring linkage model spanning over 60 data collections supported by internally developed and supported software and IT infrastructure. DLB has delivered, and continues to deliver, a range of significant data linkage innovations, many of which have been adopted elsewhere. A current restructure within the Western Australian Department of Health (which we will refer to as the Department of Health) will provide an improved funding model geared toward addressing issues with staff retention, capacity and customer service, as well as fostering improvements to data management, governance and availability. Research using linked data provided by DLB has been used in over 800 projects resulting in over 2350 publications and outcomes for policy development, service delivery and public health. Demand continues to grow for data linkage services and with the Department of Health’s bolstered commitment to resourcing, DLB looks forward to a future for data linkage in Western Australia that is sustainable, high quality, efficient, and safe

Relationship between residential aged care facility characteristics and breaches of the Australian aged care regulatory standards: Non-compliance notices and sanctions

Objectives To examine the relationship between structural characteristics of Australian residential aged care facilities (RACFs) and breaches of the aged care quality standards. Methods Facility-level analysis of audits, sanctions and non-compliance notices of all accredited Australian RACFs between 2015/16 and 2018/19. Structural factors of interest included RACF size, remoteness, ownership type and jurisdiction. Two government data sources were joined. Each outcome was analysed to calculate time trends, unadjusted rates and relative risks. Results Non-compliance notices were imposed on 369 RACFs (13%) and 83 sanctions on 75 RACFs (3%). Compared with New South Wales (NSW), non-compliance notices were less likely in Victoria, Queensland and the Northern Territory (NT), more likely in South Australia (SA), and comparable in Western Australia (WA), Tasmania and the Australian Capital Territory (ACT). RACFs with more than 100 beds and RACFs located in remote and outer regional areas (vs. major cities) also increased the likelihood of non-compliance notices. Compared with NSW, sanctions were less likely in Victoria, Queensland, NT and WA and comparable in SA, Tasmania and ACT. Additionally, the likelihood of sanctions was higher for RACFs with more than 40 beds. For both non-compliance notices and sanctions, no significant relationship was found with RACF ownership type. Conclusions We partially confirmed other Australian findings about the relationship between RACF structural characteristics and regulatory sanctions and reported new findings about non-compliance notices. Routine and standardised public reporting of RACF performance is needed to build trust that Australia\u27s latest aged care reforms have led to sustained quality improvements

Cross-sectional survey of staff and family perspectives on the use of CCTV in Australian residential aged care

Objective: To describe staff and family members\u27 opinions about closed-circuit television (CCTV) in communal and private areas of residential aged care facilities (RACF), and to investigate how this relates to perceptions of care quality. Methods: A cross-sectional survey was developed to capture perceptions of CCTV\u27s influence on care quality, and acceptable locations for CCTV placement. Data were recorded as ordinal-scale and open responses. Non-parametric tests of association were conducted. Results: The survey was completed by 81 staff and 74 family members. Both staff and family were satisfied with care quality and safety, irrespective of CCTV use. More family members were in favour of CCTV in both public and private areas, compared to staff who favoured public areas. Staff and family assumed there was real-time monitoring, leading to a belief that CCTV monitoring would improve safety and prevent falls and abuse. Concerns were raised that CCTV could be used instead of improving staff-to-resident ratios and interaction. Conclusions: Overall, participants supported the use of CCTV more in public than in private areas and believed it reveals and prevents poor care. There was no association between CCTV use and satisfaction with care. Closed-circuit television can have positive impacts if all stakeholders are involved in implementation

Academic performance of third-year medical students learning in rural settings

Investigate the academic performance of medical students in rural and remote discipline rotations by rurality of placement.A retrospective cohort study.Rural and remote clinical placement locations in Queensland, Australia.University of Queensland third-year medical students.In this study, student results for a range of assessments are the main outcome measures with rural area of student placement locations as categorised by the Australian Standard Geographical Classification - Remoteness Areas system the independent variable of interest.There was a significant effect of Australian Standard Geographical Classification - Remoteness Areas of placement on the health project, clinical case presentation, clinical participation assessment and overall grade, after controlling for the potential confounding impact of sex, age, students who attended the rural clinical school, cohort year, rotation during the year and type of health service where students were placed. No significant effect of rural placement level was identified for the written examination, poster or journal of achievement assessments.Medical students' academic achievement is associated with many factors, but this study shows that being placed in remote areas is one factor that either does not impede or can positively influence the learning and academic performance of medical students

AVALIAÇÃO DE ESTEREOTIPIAS DE EQUINOS SEMI-ESTABULADOS

Os estudos dos comportamentos equinos visam buscar respostas que melhorem a qualidade no manejo e bem-estar dos cavalos. Pensando nisso, esse estudo buscou avaliar a presença de comportamentos estereotipados e anormais em equinos semi-estabulados. As avaliações foram realizadas no CTG do município de Xaxim, com 18 cavalos adultos semi-estabulados, ou seja, parte do dia a campo e alojados em baias individuais durante a noite. O período de observação foi de 14 dias consecutivos, realizado individualmente com cada animal identificado e avaliado dentro de suas respectivas baias e soltos a campo. Foi elaborado um etograma de trabalho para observações dos comportamentos, anotados com intervalos amostrais de 10 minutos e registro instantâneo. Para comparar os dois sistemas de criação foi utilizado o teste qui-quadrado ou pelo teste exato de Fisher com nível de significância de 5%. Confirmou-se incidências de estereotipias nos equinos estabulados e o período de maior ocorrência dos comportamentos anormais foi na ausência de alimentos. Concluiu-se a importância da identificação dos comportamentos anormais e estereotipados dos equinos, para então realizar correta recomendação de manejos e assim proporcionar melhor bem-estar desses animais

Interactive effects of salinity, temperature and food web configuration on performance and harmfulness of the raphidophyte Heterosigma akashiwo

The cosmopolitan raphidophyte Heterosigma akashiwo commonly forms harmful algal blooms (HABs) in diverse estuaries discharging into Algoa Bay, South Africa, potentially leading to hypoxia, fish kills and a decline in key primary consumers. Despite the high environmental variability in these estuaries, little is known about how abiotic factors such as temperature and salinity constrain bloom formation and harmfulness of H. akashiwo. The present study therefore investigates growth, competition, and grazing interactions of H. akashiwo in laboratory experiments in response to two naturally relevant levels of salinity (15, 30) and temperature (16, 22°C), respectively. Experiments were set up with the naturally co-occurring dinoflagellate competitor Heterocapsa rotundata and two estuarine microzooplankton consumers, i.e., nauplii of the copepod Acartia tonsa and the rotifer Brachionus plicatilis. In monoculture, H. akashiwo growth was promoted at high temperature – low salinity conditions, while H. rotundata thrived under low temperature – high salinity conditions. In polyculture, H. akashiwo dominated at high temperature irrespective of the salinity regime, while at low temperature, it only dominated at low salinity and was suppressed by H. rotundata at high salinity. Grazing assays revealed highly negative effects of H. akashiwo on copepod nauplii survival and growth as well as mucus-induced immobilization, especially at high temperatures in combination with low salinity, while the estuarine adapted rotifers showed highest mortalities at the higher salinity level. The presence of H. rotundata significantly alleviated the harmful effects of H. akashiwo on both grazers, and the selectively feeding copepod nauplii actively avoided H. akashiwo when non-harmful prey was present. Overall, this study demonstrates that population dynamics and harmful effects of H. akashiwo are interactively determined by both abiotic conditions and food web configuration, implying competitor and consumer specific tolerances to the abiotic environment and their susceptibility to the harmful alga H. akashiwo

Agenda for action - transitioning to a healthy sustainable food system in Latin America

The project identified four key priorities to be developed in order to drive forward food systems transformation: 1) collaborating across multiple sectors; 2) broadening alliances and strengthening evidence-based approaches; 3) food governance based on human rights; 4) strengthening the regulatory role of states, and preventing corporate interference. These priorities underly the Agenda for Action developed by the Brazilian Institute for Consumer’s Defense (Instituto Brasileiro de Defesa do Consumidor/ Idec). The project aims towards an integrated evidence-based agenda for action towards healthy and sustainable food systems in Latin America that prioritize healthy affordable diets, while keeping greenhouse gases emissions within sustainable limits