Accommodation payment plans in residential aged care: The impact of consumer choice.

OBJECTIVE: To examine changes in accommodation payments to residential aged care facilities following the introduction of consumer choice reforms in 2014. These reforms have allowed residents to choose between making lump sum refundable deposits and/or rental-style payments. METHODS: Quantitative analysis was undertaken for facility-level quarterly data of 136 separate facilities, which were operated by six providers over the period under study. RESULTS: While the total pool of payments has grown strongly, consumers have increasingly favoured rental-style payments over lump sum refundable deposits. CONCLUSION: Consumer choice has changed the landscape of accommodation payment receipts in the provision of residential aged care services. Greater understanding is needed on how consumer preferences impact on the financial risk borne by providers and their ability to invest in future capacity.

Determination of morphological, biometric and biochemical susceptibilities in healthy Eurasier dogs with suspected inherited glaucoma.

In both humans and dogs, the primary risk factor for glaucoma is high intraocular pressure (IOP), which may be caused by iridocorneal angle (ICA) abnormalities. Oxidative stress has also been implicated in retinal ganglion cell damage associated with glaucoma. A suspected inherited form of glaucoma was recently identified in Eurasier dogs (EDs), a breed for which pedigrees are readily available. Because of difficulties in assessing ICA morphology in dogs with advanced glaucoma, we selected a cohort of apparently healthy dogsfor the investigation of ICA morphological status, IOP and plasma concentrations of oxidative stress biomarkers. We aimed to establish correlations between these factors, to identify predictive markers of glaucoma in this dog breed. A cohort of 28 subjects, volunteered for inclusion by their owners, was selected by veterinary surgeons. These dogs were assigned to four groups: young males, young females (1-3 years old), adult males and adult females (4-8 years old). Ocular examination included ophthalmoscopy, tonometry, gonioscopy, biometry and ultrasound biomicroscopy (UBM), and the evaluation of oxidative stress biomarkers consisting of measurements of plasma glutathione peroxidase (GP) activity and taurine and metabolic precursor (methionine and cysteine) concentrations in plasma. The prevalence of pectinate ligament abnormalities was significantly higher in adult EDs than in young dogs. Moreover, in adult females, high IOP was significantly correlated with a short axial globe length, and a particularly large distance between Schwalbe's line and the anterior lens capsule. GP activity levels were significantly lower in EDs than in a randomized control group of dogs, and plasma taurine concentrations were higher. Hence, ICA abnormalities were associated with weaker antioxidant defenses in EDs, potentially counteracted by higher plasma taurine concentrations. This study suggests that EDs may constitute an appropriate canine model for the development of glaucoma. This cohort will be used as a sentinel for longitudinal monitoring.

Ability of patients to recall habitual contact lens products and enhancement of recall using photographic aids.

PURPOSE: To determine the proportion of soft contact lens (CL) wearers who are able to recall their habitual products (lenses and care system) correctly from memory, and to evaluate the value of using photographic aids (PAs) to improve recall. METHODS: 103 soft lens wearers attended 2 visits to investigate their habitual CL product use. At the first visit they were asked to recall which products they were using and then to identify their products from PAs. They returned for a second visit with their products for confirmation. RESULTS: 51% correctly reported their lens brands from memory alone, which improved to 87% with the use of the PAs (p<0.001). 41% correctly reported their habitual care system from memory alone, which improved to 80% with the use of PAs (p<0.001). Females were better at recalling care system brand names than males (49% versus 27% correct, p=0.040) and wearers with more than 1 year experience with their habitual CLs had better recall than those with up to 1 year experience (63% versus 27%, p=0.014). CONCLUSION: Less than 50% of contact lens wearers were able to recall the names of their habitual lens and lens care products correctly from memory. PAs improved this recall significantly for both contact lenses and contact lens care systems.