This Is How It Happens

JENNIFER J. RANKIN of Beecroft, Australia is the author of Earth Hold. Her poems have been published in Aspect, The North American Review, Poetry Australia, and elsewhere

No compromise between metabolism and behavior of decorator crabs in reduced pH conditions.

Many marine calcifiers experience metabolic costs when exposed to experimental ocean acidification conditions, potentially limiting the energy available to support regulatory processes and behaviors. Decorator crabs expend energy on decoration camouflage and may face acute trade-offs under environmental stress. We hypothesized that under reduced pH conditions, decorator crabs will be energy limited and allocate energy towards growth and calcification at the expense of decoration behavior. Decorator crabs, Pelia tumida, were exposed to ambient (8.01) and reduced (7.74) pH conditions for five weeks. Half of the animals in each treatment were given sponge to decorate with. Animals were analyzed for changes in body mass, exoskeleton mineral content (Ca and Mg), organic content (a proxy for metabolism), and decoration behavior (sponge mass and percent cover). Overall, decorator crabs showed no signs of energy limitation under reduced pH conditions. Exoskeleton mineral content, body mass, and organic content of crabs remained the same across pH and decoration treatments, with no effect of reduced pH on decoration behavior. Despite being a relatively inactive, osmoconforming species, Pelia tumida is able to maintain multiple regulatory processes and behavior when exposed to environmental pH stress, which underscores the complexity of responses within Crustacea to ocean acidification conditions

Structural and individual costs of residential aged care services in Australia. The Resource Utilisation and Classification Study: Report 3

The Australian Health Services Research Institute (AHSRI), University of Wollongong, was commissioned by the Commonwealth Department of Health (the Department) in August 2017 to undertake the ‘Resource Utilisation and Classification Study’ (RUCS). The RUCS is an important national study commissioned by the Department to inform the development of future funding models for residential aged care in Australia. The purpose of the analysis covered in this report is to identify the drivers of care related costs that are fixed for residential aged care facilities. These are costs that relate to the characteristics of facilities rather than the care needs of individual residents. This study was the second of four separate but interrelated and overlapping studies undertaken to inform the design and implementation strategies for future funding reforms in the Australian residential aged care sector

Structural and individual costs of residential aged care services in Australia. The Resource Utilisation and Classification Study: Report 3

The Australian Health Services Research Institute (AHSRI), University of Wollongong, was commissioned by the Commonwealth Department of Health (the Department) in August 2017 to undertake the ‘Resource Utilisation and Classification Study’ (RUCS). The RUCS is an important national study commissioned by the Department to inform the development of future funding models for residential aged care in Australia. The purpose of the analysis covered in this report is to identify the drivers of care related costs that are fixed for residential aged care facilities. These are costs that relate to the characteristics of facilities rather than the care needs of individual residents. This study was the second of four separate but interrelated and overlapping studies undertaken to inform the design and implementation strategies for future funding reforms in the Australian residential aged care sector

THE MULTIPLE LOCATION TIME WEIGHTED INDEX: USING PATIENT ACTIVITY SPACES TO CALCULATE PRIMARY CARE SERVICE AREAS

Geographic health planning analyses, such as service area calculations, are hampered by a lack of patient-specific geographic data. Using the limited patient address information in patient management systems, planners analyze patient origin based on home address. But activity space research done sparingly in public health and extensively in non-health related arenas uses multiple addresses per person when analyzing accessibility. Also, health care access research has shown that there are many non-geographic factors that influence choice of provider. Most planning methods, however, overlook non-geographic factors influencing choice of provider, and the limited data mean the analyses can only be related to home address. This research attempted to determine to what extent geography plays a part in patient choice of provider and to determine if activity space data can be used to calculate service areas for primary care providers. During Spring 2008, a convenience sample of 384 patients of a locally-funded Community Health Center in Houston, Texas, completed a survey that asked about what factors are important when he or she selects a health care provider. A subset of this group (336) also completed an activity space log that captured location and time data on the places where the patient regularly goes. Survey results indicate that for this patient population, geography plays a role in their choice of health care provider, but it is not the most important reason for choosing a provider. Other factors for choosing a health care provider such as the provider offering “free or low cost visits”, meeting “all of the patient’s health care needs”, and seeing “the patient quickly” were all ranked higher than geographic reasons. Analysis of the patient activity locations shows that activity spaces can be used to create service areas for a single primary care provider. Weighted activity-space-based service areas have the potential to include more patients in the service area since more than one location per patient is used. Further analysis of the logs shows that a reduced set of locations by time and type could be used for this methodology, facilitating ongoing data collection for activity-space-based planning efforts

The Effects of Adolescent Heavy Drinking on the Timing and Stability of Cohabitation and Marriage

Based on prospective British Cohort Study data, adolescent alcohol use predicted the timing and stability of committed partnerships between 16 and 34 years (n = 3278; 59% female). Propensity score methods balanced age 16 heavy drinkers (32.4%) and nonheavy drinkers on a range of relevant risk factors assessed in infancy and childhood. Adolescent heavy drinking predicted having ever cohabited, earlier transitions into cohabiting and marital relationships, more breakups, and an increased likelihood of divorce. Gender and social class moderated these relationships; heavy-drinking working-class males were especially likely to cohabit and to experience early entry into cohabitation and marriage. Implications for practitioners focus on the benefits of reducing adolescent heavy drinking and precocious transitions to committed partnerships

Pre-adolescent children’s experiences of receiving diabetes-related support from friends and peers: a qualitative study

BackgroundWhile pre�adolescent children with type 1 diabetes receive most support from their parents/caregivers, others also contribute to their care. This study explored pre�adolescent children's experiences of receiving diabetes�related support from friends and peers. The objective was to identify how children could be better supported by their friends and peers to undertake diabetes self�management.MethodsIn�depth interviews with 24 children (aged 9�12 years) with type 1 diabetes. Data were analysed using an inductive, thematic approach.ResultsChildren gave mixed accounts of their experiences of speaking to their school/class about diabetes with some indicating that this had resulted in unwanted attention. Most individuals reported that other children had a limited understanding of diabetes and sometimes acted in insensitive ways or said things they found upsetting. Virtually all children described having a small number of close friends who were interested in learning about diabetes and provided them with support. These friends provided support in three overlapping ways, as �monitors and prompters,� �helpers� and �normalizers.� While some children described benefiting from meeting peers with type 1 diabetes, most indicated that they would prefer to develop friendships based on shared interests rather than a common disease status.Discussion and conclusionsFriends and peers provide several kinds of support to pre�adolescent children with diabetes. Health professionals could consider ways to assist small friendship groups to undertake monitoring and prompting, helping and normalizing roles. Parents, schools and health professionals could explore ways to normalize self�management practices to better support children with diabetes in school settings.</p