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Item does not contain fulltext, My analysis of iconic representations and the memory/commemoration of “Rosie the Riveter” reveals tensions within intermedial configurations. The audio-visual texts complicate the agenda of propaganda and brand themselves as disruptive of established cultural narratives. Multi- and inter-mediality allows us to overcome the notion of a text’s “intended ideological meaning” (Klinger 4) to explore its potential for multiple meanings depending on the ideological context. In the US, Rosie the Riveter has become a national symbol that started out as an icon that embodied the symbolic order in a capitalist, patriarchal work and political environment during World War II. Since icons also embody how members of the public sphere live under the political order and envision their reality in it, the icon of Rosie has received a new reading emphasizing female self-empowerment with a clear feminist agenda. Through the approval, consumption, and appropriation of “Rosie” as a feminist icon by the public, the political back-ground of American propaganda has been subverted in the postwar years and turned into something new. This specifically US context is dramatically different from the context German women experienced during the National Socialist terror regime and following the unconditional capitulation. The public disremembering of the National Socialist media campaign to persuade young women to actively engage in the war effort rendered the American propaganda all the more powerful, innovative, effective, and worthy of commemorating. Considering the media context surrounding the victory of the United States (as part of the Allied forces) over Nazi Germany, the tradition of commemorating the guilt surrounding the “unleashing of the war,” the discourse on Hitler’s “willing executioners” (Goldhagen 1), and the unique, unparalleled horror of the Holocaust (Rosenbaum), Neil MacGregor might be right to suspect that there is a silence resulting from the feeling of shame over what German

BACKGROUND: Residential aged care facility (RACF) staff often operate in isolation. Research is lacking on networking between facilities. AIMS: To explore outcomes associated with network formation between two RACFs as part of an action research approach to reducing falls. DESIGN: Action research approach with qualitative data collected. METHODS: Twelve RACF staff from two facilities in regional Tasmania, Australia, formed a falls prevention action research group. Thematic analysis was undertaken of 22 audio-recorded fortnightly group meetings. RESULTS: This was the first opportunity for participants to meet colleagues from another facility in a professional context. The formation of an inter-facility network enabled the sharing of ideas and systems related to evidence-based falls prevention activities and other issues and galvanised a collaborative focus for action. CONCLUSIONS: An action research process can be used to create an inter-facility network. Such networks can decrease staff isolation and facilitate best resident care.

Introduction: The Physiological Profile Assessment (PPA) is used in research and clinical practice for assessing fall risk. We compared PPA test performance between people with multiple sclerosis (MS) and healthy controls, determined the fall-risk profile for people with MS and developed a reference database for people with MS. Methods: For this study, 416 ambulant people with MS (51.5 ± 12.0 years) and 352 controls (52.8 ± 12.2 years) underwent the PPA (tests of contrast sensitivity, proprioception, quadriceps strength, reaction time and sway) with composite fall-risk scores computed from these measures. MS participants were followed prospectively for falls for 3 months. Results: The MS participants performed significantly worse than controls in each PPA test. The average composite fall-risk score was also significantly elevated, indicating a “marked” fall risk when compared with controls. In total, 155 MS participants (37.3%) reported 2 + falls in the follow-up period. Frequent fallers performed significantly worse than non-frequent fallers in the contrast sensitivity, reaction time and sway tests and had higher PPA composite scores. Conclusions: In line with poor PPA test performances, falls incidence in people with MS was high. This study provides comprehensive reference data for the PPA measures for people with MS that could be used to inform future research and clinical practice.

Background: Residential aged care facility (RACF) staff often operate in isolation. Research is lacking on networking between facilities. Aims: To explore outcomes associated with network formation between two RACFs as part of an action research approach to reducing falls. Design: Action research approach with qualitative data collected. Methods: Twelve RACF staff from two facilities in regional Tasmania, Australia, formed a falls prevention action research group. Thematic analysis was undertaken of 22 audio-recorded fortnightly group meetings. Results: This was the first opportunity for participants to meet colleagues from another facility in a professional context. The formation of an inter-facility network enabled the sharing of ideas and systems related to evidence-based falls prevention activities and other issues and galvanised a collaborative focus for action. Conclusions: An action research process can be used to create an inter-facility network. Such networks can decrease staff isolation and facilitate best resident care.

Introduction: Difficulty accessing pulmonary rehabilitation (PR) and the high prevalence of anxiety and depression in COPD has seen increased interest in alternative models of care such as the Stanford Chronic Disease Self-Management (CDSM) program. The effects of anxiety and depression on CDSM, and the effects of CDSM on healthcare utilisation (HCU) are largely unknown. Aim(s): To determine the effect of anxiety and depression on HCU in participants undergoing CDSM. Method(s): Retrospective analysis of a multicentre randomised trial of PR vs CDSM. 169 participants (mean age 68 years, mean FEV1 52% pred, 73 female) attended PR (8 weeks, 16 sessions; n=85) or CDSM (6 weeks, 6 sessions; n=84). Hospital anxiety and depression scale (HADS) and self-reported HCU were recorded after 3,6 and 9 months. Data were analysed via generalized estimating equations. Result(s): Across both groups, participants with high anxiety scores (>=10) had a trend towards more hospital days than others (p=0.08), whilst anxiety 'responders' (reduction >=1.5 points) had more frequent hospitalisations (beta=0.09, SE=0.05; p=0.04). Within the CDSM group, high anxiety was associated with more hospital days (beta=2.77, SE=1.01; p=0.01) but not a significantly greater need for hospitalisation (p=0.06) or more frequent hospitalisations (p=0.20). High levels of depression did not affect any outcomes relating to hospital admissions. The effect of CDSM on hospitalisations did not differ between anxiety or depression 'responders' and 'non-responders'. Conclusion(s): The effectiveness of Stanford CDSM on HCU in people with COPD appears to be influenced by high levels of anxiety but not depression.

Introduction: The limited access to pulmonary rehabilitation (PR) in Australia has resulted in renewed interest in alternative models of care in COPD such as the Stanford Chronic Disease Self-Management (CDSM). This programme aims to improve self-efficacy, which may be advantageous given the high prevalence of anxiety and depression in COPD. The effects of anxiety and depression on CDSM are largely unknown, as are the effects of CDSM on healthcare utilization. Aim(s): To investigate the impact of anxiety and depression on hospital admissions in participants undergoing CDSM. Method(s): Retrospective, exploratory analysis of a multicentre randomized controlled trial of PR vs CDSM (PRSM). 169 participants (mean age 68 years, mean FEV1 52% pred, 73 female) attended PR (8 weeks, 16 sessions; n = 85) or CDSM (6 weeks, 6 sessions; n = 84). Hospital anxiety and depression scale (HADS) scores and self-reported hospital admissions were recorded after 3, 6 and 9 months. Data were analysed via generalized estimating equations (GEE). Result(s): Across both groups, participants with high anxiety scores (>=10) had a tendency towards more hospital days than others (p = 0.082), whilst anxiety 'responders' (reduction >=1.5 points) had more frequent hospitalizations (beta = 0.09, SE 0.05; p = 0.043). Within the CDSM group, high anxiety was associated with more hospital days (beta = 2.77, SE = 1.01; p = 0.006) but not a significantly greater need for hospitalization (p = 0.056) or more frequent hospitalizations (p = 0.197). High levels of depression did not affect any outcomes relating to hospital admissions. The effect of CDSM on hospitalizations did not differ between anxiety or depression 'responders' and 'non-responders'. Conclusion(s): The effectiveness of the Stanford CDSM programme on hospital admissions in people with COPD appears to be influenced by high levels of anxiety but not depression.

Rationale Little scrutiny has been applied to how 'cost per fall' values have been calculated and applied. This paper presents discourse discussing how the cost of fall statistic could potentially be misleading when applied to inpatient health or residential care settings and provides estimates of the cost of falls and cost of falls per person. Method Burden of disease was estimated using a decision tree approach. Data informing the decision tree were drawn from a retrospective audit of 545 falls in a residential care facility, a visual observation study of 46 residents from the same facility and a cohort study of 186 residents from nine different facilities in Australia. Acute care and transportation costs were extracted from the retrospective audit using incident reports and care note review. The distribution of falls per person and associations between falls, fractures and change in resident mobility were extracted from the cohort study. The association between resident mobility and the amount of time required to perform toileting, transfer and dressing activities was extracted from the visual observational study. Results The minimum 'cost per fall' was estimated to be AUD 841 and the maximum was AUD 1024. The 'cost of falls per person' estimate was AUD 1887 (2008 base year). Conclusions This cost per fall estimate was substantially lower than three previous internationally derived estimates possibly as a consequence of how fall data were collected and modelled in these studies. Cost of falls per person may be a preferable statistic for future use. © 2011 Blackwell Publishing Ltd.

For residents in long-term care facilities, falling is a major concern requiring preventive intervention. A prospective cohort study measured the impact of falls reduction following the implementation of evidence-based fall prevention interventions in 9 Australian residential care facilities. An external project team provided a comprehensive audit of current practice. Facilitated by an action research approach, interventions were individualized to be facility- and patient-specific and included the following: environmental modifications such as low beds and height-adjustable chairs, movement alarms, hazard removal, and hip protectors. Participants included 670 residents and 650 staff from 9 facilities across 3 states. A significant reduction of falls were observed per site in the proportion of fallers (P = .044) and single fallers (P = .04). However, overall the number of falls was confounded by multiple falls in residents. Reduction in fallers was sustained in the 6-month follow-up phase. Positive outcomes from interventions varied between facilities. Further research is necessary to target frequent fallers. © 2012 Mosby, Inc.

Aims and objectives. To examine residential aged care facility staff views on using falls risk assessment tools and the implications for developing falls prevention practices in the context of an action research project. Background. Falls risk assessments play an important role in care planning by identifying and monitoring aged care facility residents most at risk of falls. Yet while such assessments are recommended in falls prevention best practice guidelines, there is little published research that examines staff procedures and views related to conducting falls risk assessments. Design. Falls risk assessments were undertaken in the context of an action research project. Method. Twelve staff members from two residential aged care facilities (RACFs) in Tasmania formed a single Falls Action Research Group, which met 22 times over a year, providing the study's qualitative data. During this time, key group members assessed 178 residents using a new falls risk assessment tool (FROP-Resi). Results. According to group members, facilities evolved from a 'tick-and-flick' approach to falls risk assessment to a more individualised, face-to-face assessment process. Group members perceived the process to be more meaningful and enjoyable for staff involved in the assessment process resulting in higher quality of assessments and leading to improved levels of falls awareness among staff, residents and family caregivers. Conclusions. An action research process is useful for facilitating a new approach to falls risk assessments, engaging aged care facility staff with falls prevention and prompting improvements in falls prevention practices. Relevance to clinical practice. RACFs need to provide opportunities for staff to meet regularly to discuss practice, identify issues and take action. By doing so, staff can engage meaningfully with best practice activities such as optimising falls risk assessment processes. © 2012 Blackwell Publishing Ltd.

This study aimed to examine whether an action research approach was effective in reducing the isolation of staff in 2 residential aged care facilities, within the context of an evidence-informed falls prevention program. A Falls Action Research Group comprising 12 nursing/nonnursing staff across 2 residential aged care facilities was established and engaged in critical dialogue and action over 12 months to improve their fall prevention activities. Through the group members' engagement, a research community was established that diminished staff isolation by engaging members in a sustained process of collaboration around falls prevention, which worked to disrupt occupational silos and challenge traditional staff hierarchies. Copyright © 2012 Wolters Kluwer Health Lippincott Williams & Wilkins.

Objective. This paper examines the quality and safety of the physical environment in Australian residential aged care facilities (RACFs). Design. Cross-sectional study. One assessor completed environmental audits to identify areas of the physical environment that needed to be addressed to improve the wellbeing and safety of residents. Setting. Nine RACFs participating in a broader falls prevention project were audited. RACFs were located in Queensland, Tasmania or Victoria and were chosen by convenience to represent high level, low level, dementia and psychogeriatric care, regional and metropolitan facilities, small and large facilities and a culturally specific facility. Main outcome measure. An environmental audit tool was adapted from a tool designed to foster older person friendly hospital environments. The tool consisted of 147 items. Results. Across all sites 450 items (34%) required action. This ranged from 21 to 44% across sites. The audit domains most commonly requiring action included signage, visual perception and lighting, and outdoor areas. Conclusions. Although not representative of all residential facilities in Australia, this audit process has identified common environmental problems across a diverse mix of residential care facilities. Results highlight the need for further investigation into the quality of physical environments, and interventions to improve physical environments in Australian RACFs.

BACKGROUND: Falls are common adverse events in residential care facilities. Commonly reported figures indicate that at least 50% of residents fall in a 12 month period, and that this figure is substantially higher for residents with dementia. This paper reports the protocol of a project which aims to implement evidence based falls prevention strategies in nine residential aged care facilities (RACFs) in Australia. The facilities in the study include high and low care, small and large facilities, metropolitan and regional, facilities with a specific cultural focus, and target groups recognised as being more challenging to successful implementation of falls prevention practice (e.g. residents with dementia). METHODS: The project will be conducted from November 2007-November 2009. The project will involve baseline scoping of existing falls rates and falls prevention activities in each facility, an action research process, interactive falls prevention training, individual falls risk assessments, provision of equipment and modifications, organisation based steering committees, and an economic evaluation. In each RACF, staff will be invited to join an action research group that will lead the process of developing and implementing interventions designed to facilitate an evidence based approach to falls management in their facility. In all RACFs a pre/post design will be adopted with a range of standardised measures utilised to determine the impact of the interventions. DISCUSSION: The care gap in residential aged care that will be addressed through this project relates to the challenges in implementing best practice falls prevention actions despite the availability of best practice guidelines. There are numerous factors that may limit the uptake of best practice falls prevention guidelines in residential aged care facilities. A multi-factorial individualised (to the specific requirements of each facility) approach will be used to develop and implement an action plan in eac

Background. Falls are common adverse events in residential care facilities. Commonly reported figures indicate that at least 50% of residents fall in a 12 month period, and that this figure is substantially higher for residents with dementia. This paper reports the protocol of a project which aims to implement evidence based falls prevention strategies in nine residential aged care facilities (RACFs) in Australia. The facilities in the study include high and low care, small and large facilities, metropolitan and regional, facilities with a specific cultural focus, and target groups recognised as being more challenging to successful implementation of falls prevention practice (e.g. residents with dementia). Methods. The project will be conducted from November 2007-November 2009. The project will involve baseline scoping of existing falls rates and falls prevention activities in each facility, an action research process, interactive falls prevention training, individual falls risk assessments, provision of equipment and modifications, organisation based steering committees, and an economic evaluation. In each RACF, staff will be invited to join an action research group that will lead the process of developing and implementing interventions designed to facilitate an evidence based approach to falls management in their facility. In all RACFs a pre/post design will be adopted with a range of standardised measures utilised to determine the impact of the interventions. Discussion. The care gap in residential aged care that will be addressed through this project relates to the challenges in implementing best practice falls prevention actions despite the availability of best practice guidelines. There are numerous factors that may limit the uptake of best practice falls prevention guidelines in residential aged care facilities. A multi-factorial individualised (to the specific requirements of each facility) approach will be used to develop and implement an action plan in eac