Aged Care Insite June/July 2013

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Information about Aged Care Insite June/July 2013
Health & Medicine

Published on March 10, 2014

Author: papaRACSi


Election 2013: What it means for the industry Page 20 Issue 77 June–July 2013 Alzheimer’s research progress  The ongoing search  for early indicators  Preventative diet Page 10

TENS: here’s how to relieve pain without drugs Recommended by pain clinics throughout the world TENS stands for Transcutaneous Electrical Nerve Stimulation. It is a drug-free method of pain relief that has been used to treat a wide variety of muscle and joint problems, as well as many other painful conditions. TENS in Labour TENS have proven itself to be a safe method to provide pain relief during labour, afterbirth pains and uterine contractions during beast feeding. Our labour TENS unit, illustrated below, has a plunger type control, the harder you press, the stronger the stimulation felt. These machines are available for sale to hospitals or hire to prospective mums. TERI-TREDS™ Non slip slippers Master Medical’s Teri-Treds™ non-slip slippers are a good alternative to non-slip socks for those after surgery, elderly people in aged care facilities and for wet areas like bathrooms, kitchens, laundries, pool areas and hydro pools. • Our finest quality slipper • New high top knit cuff for added patient comfort • Improved super flex sole for maximum patient safety • Constructed of plush terry cotton/nylon upper • The ultimate in patient safety and comfort • Designed and sized to comfortably fit everyone from toddlers to adults Address: PO Box 4063 Tregear NSW 2770 Phone: 02 9625 4924 Toll Free: 1800 621 335 Email: Web: 2 | June-July 2013 Please see our website for information on Therapod Back Care Range and other products.

contents EDITOR Amie Larter (02) 9936 8610 Journalist Aileen Macalintal production manager Cj Malgo 10 (02) 9936 8772 SUBEDITOR Jason Walker (02) 9936 8643 Graphic Design Ryan Salcedo National SALES manager SUBSCRIPTION INQUIRIES (02) 9936 8666 PUBLISHED BY APN Educational Media (ACN 010 655 446) PO Box 488 Darlinghurst, NSW 1300 ISSN 1836-1501 PUBLISHER’S NOTE © Copyright. No part of this publication can be used or reproduced in any format without express permission in writing from APN Educational Media. The mention of a product or service, person or company in this publication, does not indicate the publisher’s endorsement. The views expressed in this publication do not necessarily represent the opinion of the publisher, its agents, company officers or employees. 34 Dietary management 06 In for the WIN Dealing with diabetes Aged care providers to benefit from scheme 36 Nurse Naomi Reducing the spread of norovirus 08 Three million reasons clinical focus 38 Hygiene conscious Campaign calls for more support 10 Alzheimer’s indicator Survey results raise questions on brain plaque Facilities standards improve 34 40 Screening essential COPD and depression link 42 Standing strong Secondary falls prevention trial 12 Diet matters workforce 44 Opinion: Michael Fine Nutrition underestimated as preventative measure Workforce study provides big picture 14 Sing out loud Program breaks down age barriers 46 Industry profile: Stephen 16 Virtual assistance Muggleton New website for chronic pain suffers Leadership, business growth, future of care 48 Project focus 18 Tech alert Watch connects elderly with carers 36 policy & reform 20 Election game plan Major party policy breakdown Australia’s first charity celebrates technology 54 Opinion: Mary Casey 26 Preventative measures Mental health research redirected Benefits of real life experience 28 Call for reform 56 Life layouts Increasing concern about oral disease Design for dementia suffers Creating the right balance community 50 World champion walker 52 200th Anniversary Accommodation cost confusion continues 31 Design v. function Study aims to champion skin integrity Meet 86-year-old Heather Lee 24 Opinion: Bruce Bailey construction & design 29 Navigating the home Audited 9,215 as at Sept 2012 Transitioning into aged care The move to address a growing problem Nurses evaluate carers input (02) 9936 8703 24 practical living 32 Making the move news 04 Elder abuse 09 ED expectations Luke Bear 12 New website for elderly wins award 58 Managing rosters 50 Service delivery option The latest in incontinence research and practice open ions now t Registra ird closes Earlyb st 31 Augu 22nd National Conference on Incontinence Crown Conference Centre, Perth, WA 23 - 26 October 2013 June-July 2013 | 3

news Elder abuse ‘prevalent’ Coinciding with World Elder Abuse Awareness Day, the National Ageing Research Institute has called for elder abuse to be placed on the national agenda. By Amie Larter a ccording to clinical associate professor at NARI Briony Dow, Australia should take elder abuse more seriously, and put in place more effective ways to prevent, detect and manage the range of abusive situations experienced by older people. “We don’t exactly know what the extent of the problem is here, what types of abuse are occurring, and therefore what should be done about it. “Unlike the UK, we’ve carried out no national prevalence study of elder abuse despite the obvious benefits of knowing more about the size and nature of this type of abuse.” Leanne Groombridge, acting chief executive officer of Advocacy Tasmania, agrees that this is fast becoming a major concern – one that people are no longer prepared to hide behind closed doors. In late 2012, the Tasmanian Elder Abuse Helpline – a Tasmanian government elder abuse prevention strategy – opened its lines to callers, followed shortly by a Tasmanian government initiative, the “Elder abuse is not ok” advertising campaign. To date the helpline has received 173 calls – 35 per cent of which have been calls made directly from older people who are experiencing abuse. Another 35 per cent of callers were family members reporting alleged abuse of relatives. The remaining 30 per cent was made up of service providers and friends. “Given the number of elder abuse reports that we have received, and taking into account those which our colleagues interstate also report, it is clear that elder abuse is a significant issue … “There is outrage within communities that the elderly find themselves a victim of abuse at a time when they should be able to feel safe and enjoy the remainder of their lives,” she said. Around 3–5 per cent of Tasmania’s 4 | June-July 2013 elderly population experience some sort of elder abuse, a figure which Groombridge says will have a devastating effect both on individuals and community if not addressed adequately. “The elderly are suffering and this is quite simply an intolerable situation.” As government advertising campaigns, education for service providers and the elderly creates awareness, more pressure is being placed on authorities to have effective pathways in place to provide real assistance for those who are subject to abuse. Describing elder abuse as a sad reality, COTA Australia chief executive Ian Yates called for a national zero tolerance approach to protect older Australians. He said initiatives such as World Elder Abuse Awareness Day need to be matched by strong legislation and resources from government. “It is time for the federal government to step up and take a leadership role to get a consistent approach across all states and territories including legislation, resources and advocacy and support services.” Dow suggests education and awareness for health professionals is also important, so they know what exactly to look out for. “I think it’s really important that [health professionals] don’t feel like they need to deal with it on their own,” Dow explained. “They need training and supervisory support from managers because these can often be very tricky when you have an older person who is living in a situation where they are at risk of experiencing abuse but they may not want to do anything about it.” Michael Wynne, spokesperson on behalf of Aged Care Crisis Centre, agrees that with more aged citizens and greater stress on communities, this is becoming a more pertinent issue. However, he believes elder abuse is a reflection of the way the aged and their care is perceived in our culture. “The critical consideration is to change the culture within management and the facilities from that of a competitive business seeking to maximise profits, to that of a caring community.” “Staff who entered the profession for altruistic reasons are disheartened and alienated by the pressure on them and the misdirected focus. “There is too little positive cohesion and turnover of staff is too high. People who are likely to do these things are not identified and can get away with it.” n

2010 winners, left to right: 2012 winners, left to right: Chris McGowan Jan Wright and Raeline George representing Silver Chain, Rhonda Sawtell, Abby Dunnicliff and Shirley Nelson. Meet Australia’s best in aged care! Be there when winners in each of the following three categories are announced: Individual Organisation Team Awards dinner Sunday 4 August 2013 Doltone House Jones Bay Wharf - Pyrmont Point, Sydney Visit for more information. @HESTAACawards Winners announced on the evening will share in a $30,000 prize pool* t i ck e ON sa ts le NOW *Generously provided by: Proudly presented by: Issued by H.E.S.T. Australia Ltd ABN 66 006 818 695 AFSL No. 235249 Trustee of Health Employees Superannuation Trust Australia (HESTA) ABN 64 971 749 321.

news Aged in are to WIN O lder Australians of the future will be the beneficiaries of the recently launched: Aged Care Workforce Innovation Network (Aged Care WIN) – a lifeline for businesses struggling to cope with a rapidly changing industry. The Aged Care WIN, delivered by Community Services and Health Industry Skills Council Australia (CS&HISC), plans to help aged care providers and business prepare for reform, innovate and remain viable. Funded by $9.1 million from the federal government, through the National Workforce Development Fund, the Aged Care WIN will support organisations at a local level by reviewing business models and workforce skills in line with reform agenda. Reform Ready Reviews will be available to around 200 organisations in ten selected regions, starting July 1 2013. The RRRs will help business identify ways to remain viable in a changing environment, focusing on the areas of preparedness for change, workforce and sustainability. This will be reinforced by tailored grants of up to $15,000 to implement changes. Businesses will also be supported at regional levels to identify and support opportunities for sustainable regional initiatives. The ten regions will then come together to form a national network. Speaking from the launch, minister for higher education and skills Sharon Bird, said the network is about acting now to meet the workforce challenges of tomorrow. “Aged care is not simply about medical care – it involves the whole community. These regions will build better relationships between all organisations involved in looking after the older Australians, which will make aged care that much more effective.” Rod Cooke, CEO of CS&HISC, believes that the Aged Care WIN will help strengthen the entire aged care sector including local aged care business as well as whole regions of Australia. “Our read of the tea leaves of the future of aged care is that it is consumer-led, it is 6 | June-July 2013 A plan to keep aged care providers and related business viable while they prepare for oncoming change is winning support across the country. By Amie Larter Minister Bird (top left) with Barossa Valley CEO Phil Schmaal (l), CS&HISC’s Rod Cooke and Rob Bonner and residents delivered in the home and the community and the workforce models will have a higher skilled workforce who is able to do more in fewer visits.” He said the business model for the future is going to look different and that many will have review and change their fundamental business models. “If existing providers don’t seriously look at ‘is my business model sustainable’, they could have some challenges in keeping their business,” he said. The launch was welcomed by providers, hundreds of whom met in the Barossa Valley for the launch of the Aged Care WIN. Lucy O’Flaherty, chief executive officer of Glenview Community Inc in Tasmania, believes this will give providers an opportunity to participate in a process to improve service delivery and ensure that business systems remain competitive. “Preparing the industry to make significant changes without support and systems in place could undo all the good work that has been done over decades. “This gives organisations the opportunity to sit down and have an objective view and assessment of where we are at in the reform process. “Not only in the context of legislative changes, financial impacts and the changing demographics of clients buts also the impacts in our workforce and therefore the changing skills set that are going to be required.” Heather Nicholls, regional general manager for the Royal Freemasons’ Benevolent Institution, looks after a range of facilities in Coffs Harbour, Bellingen, Urunga, Glen Innes and Armidale. Two of these facilities fall within the NSW mid-north coast area – one of the ten regions chosen for the roll out of the WIN programs initiatives. She has worked in the area for over eight years, and was part of the former Keep Australia Working program that saw five providers in the area come together to promote aged care as a career choice. She sees the new rollout as an opportunity to continue and build upon previous work on a larger scale and reaching more organisations. “I really hope that businesses will take the information from the reviews on board, as for many, especially those in rural and remote areas, this is an opportunity to help keep their businesses viable. “It’s also about looking what we can do across the region because workforce, among others, is going to be a big issue for us all in the future,” she said. n

Images of dementia, love and family • An internationally acclaimed photographic exhibition Love, Loss and Laughter: Seeing Dementia Differently is touring the nation, aimed at spreading the message that people with dementia remain human beings and should not be defined by their condition. Launched by Alzheimer’s Australia, the exhibition showcases almost 100 photos taken by American sociologist and social photographer Cathy Greenblat. Images were taken in the United States, France, India, Japan, the Dominican Republic, Canada, Monaco and more recently in Australia. “Cathy captures the universality of the condition and the powerful emotions it creates,” said Ita Buttrose, Alzheimer’s Australia’s National President. The exhibition will remain in Melbourne throughout June, then tour Canberra, Perth Adelaide, Brisbane and finally reach Sydney in November. Researcher to probe B-12 Alzheimer’s link • ARC Future Fellow and NHMRC senior research fellow professor Brett Garner has been awarded $430,000 to investigate whether a lack of vitamin-B12 could be associated with the development of Alzheimer’s Disease. This was part of the $3 million announcement from the minister for ageing, Mark Butler. Garner said it appears that in Alzheimer’s Disease, the vitamin-B12 becomes trapped with lysosomes; specialised compartments inside neurons. “It is already known the lysosomes become dysfunctional with ageing and in Alzheimer’s,” he said. “We have evidence this prevents vitamin-B12 from performing its normal function, which could lead to the over-production of toxic metabolites, such as homocysteine and methyl malonic acid in the brain. This results in a vicious cycle, as these molecules contribute to further neuron death. Enzyme blocking key to better wound healing inbrief news • New international results from the University of Birmingham suggests that blocking a crucial enzyme which produces the stress hormone cortisol could lead to improved wound healing. This could lead to health benefits for a range of patients, including elderly patients who have undergone surgery. Results found that when an enzyme called 11ß-hydroxysteroid dehydrogenase type 1 gene (11ß-HSD1) was deleted or blocked wound healing significantly improved – meaning inhibitors of this enzyme were used to speed up wound healing. Testing was conducted on a group of mice, and it was found that by removing the 11ß-HSD1 gene, age-induced thinning of the skin with a loose collagen network was prevented. This resulted in the aged mice having skin quality similar to young counterparts. Xbox development Kinects elderly to carers • A computer science student from Edith Cowan University (ECU) has developed an application that uses an Xbox Kinect to monitor the sick, the elderly, or those with a disability. Developed for a student research project, Laurence Da Luz has created software which uses the infra-red camera and motion detection features of Kinect to observe a person’s movements while at home and to know more about the person’s regular habits. The Kinect was personalised to detect if a patient missed a meal or didn’t get out of bed. It will then contact a family member via SMS or email. Developer Da Luz said that that as 13 per cent of Australia will be over the age of 70 by 2021, there is a need for a low-cost home monitoring system that can be administered easily. Adding a little extra into super can make a big difference Many of us would love to save more for our future but feel like it’s all “too little, too late” to make a real difference. While it may be hard to believe, it’s never too late — or early — to boost your super balance. And it might be easier than you’d expect. Consider Julie, a 50 year old personal care attendant earning $30,000 per year. Julie has $20,000 in her HESTA account and plans to retire at 66. She attends a HESTA education seminar at her workplace — available to her at no extra cost. Interested in learning more about her options, Julie checks out the HESTA super calculator at She discovers that, if she makes no extra personal contributions to her super (above the contributions her employer makes on her behalf), she may have only around $141,758* ($88,339 in today’s dollars), including investment earnings, when she retires. Reviewing her budget using the HESTA budget tool, Julie realises she can afford to add $20 per week after tax to her super account. The extra $20 per week means Julie’s super could reach around $178,858* ($111,458 in today’s dollars) by the time she’s ready to retire. By contributing just $20 per week, Julie could be $37,100 better off! There are many simple ways to contribute extra to your super. $10-$20 extra per week can go a long way towards helping ensure your retirement is as comfortable as possible. Use the HESTA calculator and budget tools at to work out how much you might need, see how you’re tracking right now and the difference before and after-tax contributions could make to your super. You can also attend the next Topping up your super presentation at your workplace, read our Make the most of your super guide at or free call 1800 813 327 to make an appointment with a HESTA Superannuation Adviser. More people in health and community services choose HESTA than any other fund. *Assumptions: Investment earnings of 6.25% net per year, inflation of 3% per year, and salary increases of 1% above inflation. Figures include the government cocontribution based on proposed income thresholds for the 2012/13 financial year. Figures calculated at 2 November 2012. This example is an illustration only and is not guaranteed. Investments may go up and down. Issued by H.E.S.T. Australia Ltd ABN 66 006 818 695 AFSL No. 235249, the Trustee of Health Employees Superannuation Trust Australia (HESTA) ABN 64 971 749 321. This information is of a general nature. It does not take into account your objectives, financial situation or specific needs so you should look at your own financial position and requirements before making a decision. You may wish to consult an adviser when doing this. Investments may go up or down. For more information, free call 1800 813 327 or visit for a copy of a Product Disclosure Statement which should be considered when making a decision about HESTA products. June-July 2013 | 7

ribe ubsc S today   omprehensive and diverse range of C topics  ndependent and insightful articles I making our publications essential reading   ll our websites feature interactive areas A where users can comment directly on the conversation and debate the topics that face your industry, today and in the future   elivered free of charge, and you will D also receive weekly online updates and special content. APN Educational Media is a division of APN News and Media, serving the education and health sectors. It has a stable of publications, which combine to cover all aspects of secondary, tertiary and further education, together with a range of related professions and careers. Using the latest technology to address this range of niche publishing markets, the company has access through its books, magazines, newspapers and the internet to virtually every teacher, university student, academic and health professional in the country. APN Educational Media has identified the importance and dynamism of the education and health sectors and is growing and adapting with these industries, working in successful partnership with a large range of educational and health institutions and industry bodies. APN Educational Media is not just covering the education and health industries - it is a part of them. SUBSCRIPTIONS Aged Care INsite agedcareinsite T: (02) 9936 8666 Campus Review campusreview Education Review edreviewau Nursing Review nursingreviewau

e from just $75! Subscrib The latest news and resources for aged care professionals Aged Care Insite provides the best in original journalism and is the authoritative source of news and analysis for the residential and community care sectors. •  omprehensive coverage of a diversity of topics affecting C the Aged Care sector • News and information medical matters and product news •  nalysis of the major issues facing the Aged Care sector as A a whole. • 6 issues per year • Editorial integrity and industry relevance •  eeps industry professionals up-to-date on the politics and K policy that matter • Tax deductible |

news Millions of reasons why As more and more Australians are prevented access to age services, the government must fund more care and services. By Aileen Macalintal E very 71 minutes an Australian is denied age services. Since Medicare does not universally fund age services, Australians must rely on family as they are placed in a vulnerable position. To address this, a campaign called Three Million Reasons has been launched in a move to secure a safety net for their health. Retired general Peter Cosgrove launched the Three Million Reasons campaign in Sydney, promoting and supporting the age service workforce, as well as highlighting the need for critical planning and smarter funding of aged services. Cosgrove is the chair of Leading Age Services Australia (LASA), the industry’s peak body. “Three Million Reasons is based on the fact that there are three million Australians aged 65 and over,” said Cosgrove, quoting a statistic from the 2011 Census. “As Australians live longer, this number will double by 2050. Despite age services being in the midst of reform, there is much more we need to do in order to meet the demands, today, let alone the looming liability,” he said. LASA CEO Patrick Reid said support for the industry must triple in the next 30 to 40 years. Reid said, “The age services workforce 8 | June-July 2013 must triple by 2050, and in last week’s budget $80 million was clawed back from Health Workforce Australia. This is a worrying sign, and does not suggest the government is taking the need to support and grow the workforce seriously. “The numbers are real and they are quite sobering; 83,000 beds need to be built in residential aged care in the next nine years at an estimated cost of $17 billion,” he said. The government has recently delivered a pay rise to age service workers who are receiving low wages, and this will be funded from the budget that provides direct care and services to older Australians. However, LASA believed this is not a sustainable strategy and that the workforce deserves better. Age services matter not only to current recipients but every Australian who in the future will need the services. The Three Million Reasons campaign is also engaging politicians to ensure that the care of older Australians is taken into account in the lead-up to the September 14 election and beyond. “In the lead-up to the election, this issue will again be highlighted and this campaign will publish the federal politicians committed to helping older Australians to live well,” said Cosgrove. “Despite age services being in the midst of reform there is much more we need to do in order to meet the demands today, let alone the looming liability,” he said. During the campaign launch, Beth Cameron Cosgrove spent the day meeting with many elderly Australians and the carers, hearing their stories and the difficulties they encounter on a daily basis. Beth Cameron, CEO of LASA WA commended Cosgrove’s campaign in support of better age services throughout Australia. “Australia needs a significant increase in age services to meet the enormous demands of our ‘ageing’ population, which means more government funding that reflects the true cost-of-care,” Cameron said. “The staff and providers of age services overcome enormous challenges in maintaining the standards of care we all expect. “Three Million Reasons will highlight that our older Australians need more support which is placed squarely on the shoulders of our age services and their workforce,” she said. n

news Carer issues Carers, cognitive decline and complex health issues can make managing the elderly in an emergency department presentation a difficult situation to handle. By Amie Larter A recent study has zoned in on the interactions between emergency nurses and older patients’ family and carers, as an increasing number of elderly people are entering Australian hospitals via emergency departments. Prone to cognitive decline and the common presence of complex health issues, elderly patients who present to the ED generally require more immediate attention, have longer stays and are more likely to be admitted. A team of researchers from the University of Technology, Sydney surveyed 27 nurses from a 550-bed emergency department in Sydney to explore experiences and expectations with family and carers accompanying older patients. Published in the Nurses’ experiences and expectations of family and carers of older patients in the emergency department report, results suggested that “unvoiced and potentially unrealistic expectations” between ED nurses and family are resulting in conflict. The study found carers were deemed to be helpful if they saved the nurses time; and obstructive if they cost time. Frustration was experienced with carers who invested little time with the older patient. Equally as testing were carers that were regularly present but demanded too much time with the ED nurse. According to Robyn Gallagher, associate professor of chronic and complex care, Faculty of Health, University of Technology, Sydney, it was clear that nurses were stressed and worried about getting things done in a timely way. “[Nationally] there has been a directive from the government that everyone should be in and out of the emergency department in four hours … that’s not going to work for older people that might have three different illnesses at the same time.” Describing nurses expectations as “pretty tough”, Gallagher pointed out that in most cases, this was due to genuine concern about the rights of the elderly patients. “Nurses did not tolerate family getting in the way of them communicating with their patients properly,” she said. “It was very gratifying to find out how concerned nurses were with that, and that the older person was being heard and supported.” In one instance, a nurse involved in the study reported the daughter of an elderly patient was adamant that she was the guardian of the patient – and all questions should be directed to her rather than the patient. Nurses viewed situations like this as an “infringement on both the patient’s rights and the nurse’s duty to involve the patient”, according to the report. Liz Cloughessy, executive director of the Australian College of Emergency Nursing believes that nurses do work very hard to meet the needs both of the patient and their family or carers; however the ED is simply not designed for the elderly. “It’s busy, it’s noisy, there is a lot of light, movement and increased stimulation. The actual environment itself is not designed for the older person – especially someone that is a little bit confused or a little bit frail,” she said. Cloughessy confirmed that throughout NSW, most bigger hospitals have aged care nurses working with the emergency team, while medium-sized hospitals generally had access to aged care consultants. “We refer them to come and see the elderly patient and do a determination on their home, cognition and where they are at, and we value their opinion in helping us to determine pathways we will take. “This is a very important and heavily funded initiative.” Gallagher agrees, suggesting what’s needed is specialist aged care nurses on rotating shifts. She also suggests that ED nurses require positive leadership role models. “Nurses look up to senior nurses like educators and consultants. I think if those nurse behaved really positively then other people would model that.” Gallagher says one of the next steps will be to develop brief workshops for emergency nurses on how to work with older people. n June-July 2013 | 9

news Alzheimer’s indicator too late to help New research shows brain plaque, the standard indicator of Alzheimer’s disease for decades, is not the main driver of neurodegeneration and memory loss first thought. By Aileen Macalintal T he discovery, made by two Sydney researchers, is set to fire further debate on the diagnosis and treatment of Alzheimer’s. PhD student Amanda Wright and Dr Bryce Vissel from Sydney’s Garvan Institute of Medical Research are the lead authors of Neuroinflammation and Neuronal Loss Precede Plaque Deposition in the hAPP-J20 Mouse Model of Alzheimer’s Disease. Wright and Vissel studied a mouse model of Alzheimer’s disease to identify early versus late disease mechanisms and markers. Their data suggests that plaques occurred much later in the brain, well after significant memory loss. Thus, plaque may not be useful as an early pathological marker for Alzheimer’s disease. The investigators found that significant nerve cell loss and inflammation began as soon as subtle memory problems appeared, which was early in the disease process. Plaques are a build-up of a substance that does not normally occur in the brain, explained Wright and Vissel. “To put into simple terms, the best way to imagine it is that under the microscope it looks similar to tooth plaque. However, it is a completely different substance,” they said. In 1906, Alois Alzheimer first identified plaque in the brain and, many decades later, it was discovered that the plaque is made up primarily of a substance known as amyloid beta. “In fact, amyloid beta occurs normally in the brain. However in Alzheimer’s disease, this substance clumps together to cause plaques. This is a gradual process and can take many years, even decades, for plaques to develop in the brain,” they said. The role of plaque in Alzheimer’s disease is controversial, said the researchers. “From our study we have concluded that plaques do occur in the brains of mice with Alzheimer’s disease, though they are not the major driver of neurodegeneration and memory loss,” said Vissel and Wright. In other words, it shows that memory loss and neurodegeneration 10 | June-July 2013

news It is still controversial as to whether mild memory loss is necessarily a precursor to Alzheimer’s disease. may be early events in the disease. If it’s not the plaque that marks the disease, what do the researchers regard as the conclusive marker of Alzheimer’s? “It is still unknown what would be a great marker for early detection of Alzheimer’s disease. Our study has shown that inflammation occurs very early on in the disease process.” “We hypothesise that one way to track Alzheimer’s disease is to look at particular markers of inflammation in conjunction with sophisticated cognitive testing.” Vissel said their study supports the increasingly common view that treatment should start much earlier. Various studies have pointed out that mild cognitive impairment may be another early predictor of the disease, he said. He defined mild cognitive impairment as “a loss of memory without loss of cognitive function. This is detected by a general test for memory, mainly by what is called the Mini Mental State Examination”. This involves thirty questions that test orientation, language, recall and repetition. The score can indicate whether cognitive impairments are severe, moderate or mild. “However, it is still controversial as to whether mild memory loss is necessarily a precursor to Alzheimer’s disease,” said Vissel. The authors went on to explain that people with Alzheimer’s appeared to not have benefitted from recent clinical trials of drugs designed to prevent plaque buildup. Questions have already been raised about the best strategy for treatment. Wright and Vissel said their research fits into this debate in three ways. “First, it shows that disease occurs well before plaques have appeared which suggests that delivering treatment early in disease, even before plaques, might be sensible. In simple terms, we should probably start treatment before the horse has bolted. “Secondly, it raises the question as to how to identify Alzheimer’s disease early since our study suggests that plaque is a last event in Alzheimer’s and as such is not a good indicator of early disease. “Thirdly, it raises the question as to whether other therapeutic strategies besides targeting plaque may offer better approach to treating Alzheimer’s disease.” Their findings may yet make previous research into the disease null and void, but it builds on the potential to develop future studies. “This study changes the way we think about Alzheimer’s disease,” said the lead authors. The use of recent imaging agent to detect plaques for diagnosis, for instance, may change, said Vissel, as their findings provide implications for the way researchers may be able to detect and treat Alzheimer’s disease. Dr Chris Hatherly, national research manager of Alzheimer’s Australia, said this study is an important development that builds on what is known about the diseases that cause dementia. “It adds to a number of recent findings – including disappointing results from major drug trials – that suggest we need to look further than the amyloid protein to better understand and eventually treat Alzheimer’s disease and other forms of dementia,” said Hatherly. n AGED CARE NURSING SCHOLARSHIPS Open 1 July 2013 – Close 30 August 2013 Aged Care Nursing Scholarships are available for: Undergraduate > For those with a demonstrated commitment to aged care wanting to become a registered nurse. Postgraduate > For registered nurses working in aged care wishing to further their studies. Nurse Practitioner > For registered nurses working in aged care wishing to undertake studies leading to endorsement as a nurse practitioner. Continuing professional development > For registered and enrolled nurses working in aged care wishing to attend a short course, workshop or conference relating to the care of older people. Nurse re-entry > For formerly registered or enrolled nurses whose registration has lapsed wishing to re-enter the nursing profession with a focus on aged care. DEVELOP AND SHAPE YOUR AGED CARE CAREER freecall 1800 116 696 Aged Care Nursing Scholarships (ACNS) are funded by the Australian Government. ACN, Australia’s professional organisation for all nurses, is proud to work with the Department of Health and Ageing as the fund administrator for this program. June-July 2013 | 11

news Preventative for The need for closer attention to diet increases with age. By Aileen Macalintal G rowing evidence shows people with early Alzheimer’s disease have low levels of certain nutrients compared to healthy individuals of a similar age. People with Alzheimer’s, for instance, may need to particularly address low vitamin B12 levels that lead to fatigue and worsening of symptoms. “As for people of any age and with or without a health condition like Alzheimer’s disease, a healthy and balanced diet is necessary for optimal brain function,” says Glenn Rees, CEO of Alzheimer’s Australia. “If you already have Alzheimer’s disease or another form of dementia, good nutrition may help to mitigate physical health problems that would be difficult for a person with dementia to articulate. “There is a considerable body of evidence that environmental and lifestyle factors including nutrition may help brain health and be protective against dementia, which is important for carers and family members,” Rees said. He said the brain needs a range of nutrients, fluids and energy to work properly, but the relationship between food and dementia risk is not fully understood at this stage. Evidence suggests that a high intake of saturated fats and sugars may increase the risk of developing dementia, he said, and “it is likely that a diet that includes a higher consumption of fish, fruits, vegetables and healthy fats in vegetable oil and nuts, and a lower intake of saturated fat in meat and dairy products can help in keeping the brain healthy”. Alzheimer’s and other forms of dementia have a significant impact on the Australian healthcare system, and finding treatment and management is important. Professor Michael Woodward, geriatrician, director, memory clinic and director of Aged Care Research, Melbourne says that nutrition, and its role in managing the early stages of Alzheimer’s disease, cannot be underestimated. 12 | June-July 2013

news eating Alzheimer’s “Medical nutrition is increasingly understood as a useful, and important, component in managing patient health,” said Woodward. “Alzheimer’s disease is a devastating neurodegenerative condition, affecting memory, daily living and independence, causing substantial distress to family members and or loved ones who often become carers. Currently, effective treatment options for Alzheimer’s disease are limited,” he said. One of the management options for the disease is the medical food Souvenaid, clinically proven to nutritionally support memory function. After 10 years of research and development into the role of diet and nutrition and Alzheimer’s, Australian specialists and Alzheimer’s Australia support the multi-nutrient drink. To achieve the nutrients provided by a once-a-day bottle of Souvenaid (125ml), in addition to their normal diet, a person would need to consume one kilogram of tomatoes, 1.2 kilograms of broccoli, 710g spinach, 100 grams fresh tuna (or four tins of tuna), 100 grams minced beef, four eggs, one orange, and a handful of brazil nuts. The brain needs these nutrients in the processes related to learning and memory. This combination of nutrients may be difficult for people with Alzheimer’s to achieve at certain levels from normal dietary intake alone. Aged Care Research has welcomed the introduction of Souvenaid as a new nutritional management option for those living with mild Alzheimer’s disease. “Souvenaid is not a cure or preventative measure for Alzheimer’s disease,” Woodward said. “It is however a significant advance to the nutritional management of memory function during the early stages of Alzheimer’s disease.” Rees explains that “medical food” is a category of food product designed to provide some form of medical benefit, usually with minimal risks to the consumer. “Souvenaid simply gives people with mild stage Alzheimer’s another option. The research to date has only established that Souvenaid is helpful for people in the early stages of the disease, and it only acts to improve memory, not other aspects of the condition,” said Rees. He said, “It does not stop the progress of the disease in any way, and it does not work for all or even most people, but for some (around 40 per cent, according to the research) it may slow down, and temporarily improve memory function.” The multi-nutrient drink is now available nationwide. “Since starting Souvenaid in February, my husband’s whole demeanour has changed,” said Suzane, who is caring for a husband with Alzheimer’s. “His sense of humour is like it was when we were younger. He is more willing to fill his day with activities like gardening, whereas before he would mope around and not do much at all.” n June-July 2013 | 13

news Knox student Molly (left) and Pat Turner, 94, share a laugh. Today’s youth and yesterday’s sing together A new installment in a program that brings together the elderly and the young to make music is breaking down the barriers of age. By Amie Larter C ontinuing its commitment to bring arts to the aged care environment, the Arts Health Institute (AHI) has launched its second round of their Sing Out Loud program – after a successful pilot in 2012. The intergenerational program, which sees schools form a partnership with a local aged care facility, see primary school students build friendships with an “elderly buddy” over the course of eight weeks. 14 | June-July 2013 The two original schools involved in the pilot are back on board this year, joined by another five, and AHI CEO Maggie Haertsch confirmed they are hoping to see the program grow nationally. “We felt that if there was a way that children could come and sing over a period of time – not just a once-off – then there should be some really good benefits in terms of building better relationships with the elderly,” she said. “We really want to create neighborhoods’ that connect the school and the aged care facility ... and we felt that putting a choir together would really build that sense of community.” The structured program sees school students visit their paired aged care facility weekly, where rather than coming to entertain the elderly, the students are coming into engage, socialise and sing with them. The program uses music to promote social engagement, elicit positive emotional and behavioral response and stimulate cognitive functioning in both healthy elderly and people suffering dementia. The elderly residents teach their buddies songs from their era and answers different questions for students writing and research tasks. This culminates in a musical performance in the eighth week – where the elderly have the chance to sing with the students at the school hall. Most recently, a group of primary students from The Knox School in Victoria’s Wantirna South partnered with residents from Australian Unity’s Victoria Grange Aged Care as part of the program. Year 6 student Molly, who was partnered with 94-year-old Pat Turner, says she has seen that music brings back memories

news from when her elder buddy was young. Her favourite parts of the program included getting to know Pat, and learning different types of music. “The music is very different – they are simple songs but they are touching. Their songs are quite short but they are very moving because they show love, friendship, respect: just simple things.” The students and buddies will join together on June 27 for the choir to perform, an event that Pat is very much looking forward to. “I used to sing in choirs when I was younger so it will be good to perform again with the mixed group of residents and students,” she said. “[Molly] said she enjoyed learning all of the songs but she was not familiar with any of them. “I told her that I knew all of the words and really didn’t need to look … when I was young it was common for families to sing around the piano every Sunday night. It was one of the main forms of entertainment in the home as there was no TV and no radio.” Boyd Williams, Year Six teacher at The Knox School, said this is a remarkable program – one that helps students foster the value of respect, kindness, empathy and maturity. “We certainly focus a great deal on these things in our class but to have the real life opportunity to watch these qualities grow is outstanding … students are able to see that there is more to life than One Direction, Justin Beiber or their iPad. “The program also enables some of the social aspects and values to develop as a consequence of the friendship formed with their new friend. Respect, dignity, trust are just three of the words that come to mind when I watch the interaction between the children and their new friend.” The program integrates aspects of English, art music, HSIE and technology and forms part of the school curriculum and service learning unit. Students at The Knox School reflect on their time with their elderly buddy by writing about their reflections on the experience, producing literature Williams describes as “revealing” and “heartfelt”. For managers, senior managers and aged care workers looking to bring more creativity into their work, the Arts Health Institute is holding the first National Play Up Convention at Luna Park in Sydney on September 5 and 6. The keynote address for the event will be Dr Stuart Brown, psychiatrist, author and Founder of the National Institute for Play in the United States. Brown authored the book Play: How it Shapes the Brain, Opens the Imagination and Invigorates the Soul. n Celebrating life and diversity Classic hits, dancing and fun were on the agenda for the elderly crowd that attended the 13th bi-annual Celebration of Life event last month. V ictorian aged care facilities joined together for a cultural themed afternoon of fun – aimed at offering a free-of-charge opportunity for residents to socialise with residents of other hostels and nursing homes. Held at Northcote Town Hall – a popular meeting place for many of the elderly back in their younger days – the afternoon was opened by the people’s priest, father Bob Maguire, and entertainment included headlining senior’s band The Huffers and Puffers, as well as other ethnic musicians and a belly dancer. Attendees were encouraged to dress in their national clothing or any type of traditional dress for the event, and the room boasted flags from over 30 countries. Named “A Celebration of Cultural Diversity”, the Centre for Cultural Diversity collaborated with the Celebration of Life Group to host the event – celebrating cultural diversity in ageing. “The biggest highlight of the event was looking around the ballroom and seeing people dancing, smiling and hearing lots of laughter,” said Trish Crowe, lifestyle coordinator at Mary MacKillop Aged Care. “When you see the positive impact these events have, it’s worth all the hard work.” Staff, helpers and family were joined by primary school students and young adults – who not only assisted with the event but performed, as well as socialised and danced with residents. Paul Brophy, manager of the Brotherhood of St Laurence’s Sambell Lodge residential aged care facility originally developed the idea to host the event back in 2006, and says it’s a way to show residents that living in a facility no longer means being cut off from your community. “We are helping our elderly people who are living in aged care facilities to get out there, to get out into the world and enjoy life, and have some fun meeting other people in facilities in the community. “We all like having something to look forward to, and our elderly citizens are no exception.” Planning is already underway for the next event in October. n June-July 2013 | 15

news Managing persistent pain For those struggling with chronic musculoskeletal pain, help is virtually at hand. By Aileen Macalintal A website has just been launched in collaboration with the Department of Health (WA) to help people manage chronic musculoskeletal pain. Associate professor Helen Slater from Curtin’s School of Physiotherapy said the website – called painHEALTH – has the potential to help the estimated one in five Australians who suffer from this chronic pain. “Musculoskeletal pain is basically pain that comes from muscles or joints or other soft tissues such as tendons and ligaments. It can include nerve pain,” said Slater. Musculoskeletal pain may start in childhood, but the particular targets of this website are adults, especially since the prevalence of this pain increases around 40–60 years of age. Slater said a very substantial health burden related to persistent pain, of which musculoskeletal represents a sizeable proportion, prompted the website’s creation. In 2007, the health economic burden for chronic pain in Australia was estimated at $34.3 billion or $10,847 per person, said Slater. The National Pain Strategy reported that 20 per cent of visits to general practitioners are due to chronic pain and around 25 per cent of these persistent cases are for musculoskeletal pain. A real gap exists in service delivery For those who care about how their home looks For many years CareWell Health has been helping people choose better equipment and furniture The people we have typically helped were worried about the look of their care home; irritated by damage done to the walls; sick of maintenance not done or repairs dragging on; and worried about getting value for money. We can help you make your residents feel more at home Model shown here is the Freya in beech veneer. For further details please contact our toll free number or email. Toll free 1800 30 32 88 16 | June-July 2013 email for consumers with persistent musculoskeletal pain. She said there is a good evidencebased management, but despite that, only around 10 per cent are estimated to get this management. “So in Western Australia, we wanted to try to close the gap and upscale consumers about the current evidencebased management and apply it, how they can get those treatments, and what they can do themselves,” she said. The site will assist people with low back pain, neck pain, osteoarthritis, rheumatoid arthritis, osteoporosis and complex regional pain syndrome to better manage their pain condition. Australians can benefit from painHEALTH in practical ways too. “It doesn’t just give current evidence and knowledge, but importantly, it also

news provides training module or skills that they can engage themselves,” said Slater. The website features videos, meditations, and a comprehensive guide through seven different modules that can help people in pain integrate and get a more holistic approach to pain management. One video shows a woman named Rose who said, “Life is hard … Don’t pretend that it’s not. The power to overcome [pain] is in your head.” Slater likes the fact that the website takes a whole personal approach. Usually, a number of professionals are out there to give people advice, and it is left to them to try it, she said, “but in the website, we try to give a more holistic and personal approach. That’s really what the consumers, like Rose, want to talk about and find most beneficial. “It’s going to be promoted through multiple mechanisms. It’s very, very important that we have all the health professionals on board,” she said. They are promoting it through professional associations across Australia including the Royal College of General Practitioners, Australian Pain Society, Australian Psychological Association, Australian Osteoporosis Association, nursing bodies, universities and all worthwhile peak bodies. n View the website at | 1300 886 814 Check out the full product range online. a stocktds akget 31 u us en sale prices inc gst June-July 2013 | 17

news Who watches the watch? New steps in remote monitoring are leading toward more independent living. By Aileen Macalintal R emote caregiving will now be possible with the timepiece from family-owned company mCarewatch. Aside from telling the time, the lightweight SOS mobile watch works as a phone, GPS locator and SOS emergency alert. This technology allows the elderly to live independently and in their preferred environment. Paul Apostolis, director of mCareWatch, shared that the idea for the SOS Mobile Watch came after his family had a scare. “My father became disoriented while out with my mother one day. He couldn’t speak properly and had difficulty driving but insisted that he was fine and by some miracle they made it home safely but it was clear that he wasn’t himself. As we later discovered, my father had experienced a stroke,” said Apostolis. He said his elderly parents seldom use their mobile phones, often leaving the TA R G E T I N G YO U R devices at home or uncharged. “Following market research and contacting leading aged care and community bodies, it became clear to both me and my brother Peter, that our family is not alone.” Apostolis and company co-founder Peter Apostolopoulos have business experience in information technology, healthcare and personal care to create a range of solutions that free older people. The watch came out in their search of an alternative to the traditional emergency pendant alarms. “There’s a whole ‘sandwich generation’ of Australians torn between the demands of work, caring for young families and caring for older parents or relatives,” Apostolis said. He said not only will the elderly be ensured their independence, but carers too will have a peace of mind since the watch wearer can press a single button in an emergency to automatically call their nominated carers. The carers can also locate via the wearer who may be incapacitated or unsure of geographical location of incident. The location of their loved ones can also be tracked anywhere, any time by using the GPS function via their smartphone using Google maps. For Apostolis, the best features of the M A N A G E M E N T N E E D S watch include the two-way communication at the press of a button and the SOS button that automatically dials up to three carers in an emergency. “The other amazing feature of the watch is the SMS-command activated two-way communication if wearer is not responding and is incapacitated. The SMS command is sent from the carer’s mobile to the SOS Mobile Watch, which then opens up a channel to communicate and listen to the wearer without them having to press a button,” he added. In addition, the wearer is not confined to a restricted monitoring area as SOS mobile watch works with Optus mobile digital network that covers 97 per cent of the Australian population. “Technology is a great enabler to address issues and problems in aged care faced by families and service providers. By investing in technology, it will allow all stakeholders involved in the care of the individual to be conducted in more effective and efficient way, particularly with an ageing population and the pressures on our aged care/ health care workforce,” said Apostolis. He said the next model will have features that include monitoring daily living patterns and the capture and sharing of specific health parameters. n Aged Care Financial Management Solutions just a phone call away 1300 651 321 AIM Software provides a fully integrated suite of modules: • General ledger • Asset register • Accounts payable • Accounts receivable • Payroll & Rosters • Community care Our excellent after-sales service and support is a standard feature. AIM also provides Payroll Bureau and Outsourced Financial management services. No need to worry if unexpected staff shortages occur… AIM can provide short, medium or long term assistance through its Bureau services. Unit 33, 41– 49 Norcal Rd Nunawading Victoria 3131 T 03 9264 8700 F 03 9872 3709 E W 18 | June-July 2013 AIM_InsiteAd_185x90_Feb2013.indd 1 18/02/13 8:25 AM

calendar 2013 • LASA National Congress 2013 JULY • Nurses In Management Aged Care (NIMAC) Conference and Trade Exhibition 4–5 July Queensland • National Diabetes Week 14–20 July Nationwide 15–18 July Adelaide Convention Centre 5–6 September Luna Park, Sydney NSW NATIONAL CONGRESS 2013 Leading Age Services Australia  INVITATION gratefully acknowledges the support of our sponsors  to date: On behalf of the LASA National Board I invite you to join us in Sydney in August for what will be the premier industry networking event. Platinum Sponsor Our industry understands we face considerable challenges and yet continues to provide high quality care and services to older Australians. With challenges comes opportunities and that's exactly what Congress 2013 will explore. New Frontier: New Focus will hear from trailblazers who have succeeded against considerable odds; inspiring individuals who have changed cultural thinking, business operation and ingrained their approach within the Australian psyche. Age services can learn much from Mark Bouris, Jon Dee and Todd Coates. Our industry will also be informed and inspired with assistive technology practices that will greatly enhance human capital and the ability to focus on care. This Congress also includes innovative study tours and a special master class. We're delighted to introduce a number of new innovative partnered sessions with the Australian College of Nursing, Better Boards Australasia and the Australian Institute of Management. The 2013 Congress will be facilitated by two expert master of ceremonies, Andrew Klein and Toby Travanner, with specialist audience participation technology allowing you to guide discussion. This is a Congress not to miss! • Daffodil Day 23 August Nationwide • Hearing Awareness Platinum Sponsor caresystems • National Stroke Week Platinum & Congress  Dinner Sponsor o Bronze Sponsor Massage Booth Sponsor 9–15 September Nationwide national-stroke-week Lanyards Sponsor Welcome Reception Sponsor CONGRESS PLANNING COMMITTEE Patrick Reid – CEO, LASA Charles Wurf – CEO, LASA NSW­ACT Cynthia Payne – CEO, SummitCare Robert Orie – CEO, Sir Moses Montefiore Jewish Home Deborah Key – Director of Nursing, St Luke's Care Steve Gordon – Director, Gordon Group Jacqueline Murkins – Projects Manager, LASA  Justine Caines – Government Relations & Communications Manager, LASA Kay Richards – National Policy Manager, LASA Stuart Bicknell – Manager Member Services, LASA NSW­ACT Laura Barnes – Events and Administration Coordinator, LASA NSW­ACT Barry Neame – Congress Manager, Consec – Conference Management CONGRESS MANAGERS Week 2013 25–31 August Nationwide 25-31 Patrick Reid Chief Executive Officer Leading Age Services Australia • Health Informatics • National Play Up Convention 5–7 New Frontier: New Focus August Sydney Convention & Exhibition Centre, Sydney NSW 2 Consec – Conference Management As agent for Leading Age Services Australia PO Box 3127  BMDC ACT 2617 Australia T: +61 2 6251 0675 E:  Pressure Weights For no; one-Educating Patients and Families The Best Care for older People Everywhere Toolkit Creating Champions for Skin Integrity to Reduce the Prevalence of Pressure Injuries Within Residential Aged Care The Implementation of a Hospital Wide Wound Care Program Responding to the Challenges Created by the different Shapes of the obese The Post Conference Workshop: Wednesday 18th September 9.00am –12.30pm Putting Pressure Injury Prevention into Practice for Hospital, Community and Residential Aged Care Facilities Led by Debbie Blanchfield, Wound Care Clinical Nurse Consultant, Surgical Stream, Wollongong Hospital • Dementia Awareness Week • Jean Hailes Women’s Health Week 28 July Worldwide AUGUST • Better Practice 2013 – Adelaide 15–16 August Hilton Adelaide, SA The Wound Centre | Alfred Health DO NOT MISS! SEPTEMBER • World Hepatitis Day Australia | Pressure Ulcers | Royal Darwin Hospital | QUT Wound Healing Service | Translating Research into Clinical Practice Change Pressure Injuries & the Indigenous Community in the northern Territory • Prostate Cancer Awareness Month 25–26 July Prevention Project Group | The Prince Charles Hospital | Western Health | Melbourne Health | Australian College of Critical Care Nurses | Prince of Wales Hospital | University of Western Wound Champion Program – A network of Far-Reaching Tentacles • Better Practice 2013 – Sydney Sutherland Hospital | St Vincent’s Health Network | Australian Bariatric Innovations Group | The St George Hospital | ACI/ICCMU Pressure Injury The Prevention of Pressure Injuries in People with Spinal Cord Injuries 22–28 July Nationwide chronicpainaustralia. org With key contributions from: Pressure Injury Prevention during the Surgical Patient Journey Pressure Injury Risk Assessment in Intensive Care Best Practice Guidelines for Pressure Injury Prevention in the Adult Intensive Care Patient • National Pain Week Th loo e on kin ly co g n of sole fere pre ly n ss at th ce in ure e A inju pre ust ries vent ralia ion Meeting Standard 8, our Experience Notes Office of Hearing Services 2nd Annual A comprehensive case study led program covering: • ACHSM: Asia Pacific Congress on Health Leadership 28–30 August 2013 Rydges Lakeside Canberra, ACT Reducing Avoidable Pressure Injuries Conference 16–17 September Novotel Melbourne on Collins, Victoria 16–17 September 2013 | Novotel Melbourne on Collins To Register visit: August 2013 • 2nd Annual 1–30 September Nationwide 2–6 September Nationwide • 12th Australian Palliative Care Conference 3–6 September National Convention Centre, Canberra, ACT 16–22 September Nationwide Australia’s leading healthcare conference provider This conference is endorsed by APEC No 090810001 as authorised by Royal College of Nursing, Australia (RCNA) according to approved criteria. Attendance attracts 12 RCNA CNE points as part of RCNA’s Life Long Learning Programme (3LP). In addition, by attending the postconference workshop you will earn an additional 3 RCNA CLE points. Endorsed by: The Wound Centre TO REGISTER: VISIT: T: +61 2 9080 4090 E: • Better Practice 2013 – Melbourne 19–20 September Hilton on the Park, Melbourne, Victoria • World Alzheimer’s Day 21 September Worldwide • Parkinson’s Awareness Week 25–30 September Nationwide beyondblue training for BOOK community care staff NOW! World Hepatitis Day 2012 has released its latest beyondblue Viral Hepatitis Awareness Events Professional Education to Aged Care (PEAC) Program targeting care staff working in the community. Page 1 of 16

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