Introduction: Allied health services in rural and remote hospitals often work in siloed and solo discipline-specific positions. They are often part of general multi-disciplinary teams without a clearly articulated service model that integrates care for individuals and addresses broader community health needs. Integrated care service models for clients with complex disabilities or chronic health needs have demonstrated improved outcomes, but feasible service models are rarely described in the context of rural, remote and First Nations communities. Integration can support primary care in remote communities where resources are thin, and the breadth of multidisciplinary service providers is not available. To respond to the context, a co-designed student-assisted, community rehabilitation and lifestyle service was developed to support three very remote communities. Context: This study was based in three very remote (modified monash model 7) communities in Cape York, Far North Queensland. Two of these communities are discrete Aboriginal communities, with many services based in the third community which acts as a ‘hub’ community for the surrounding region. Engagement: Over a 4-year period, this service was co-created (co-designed and co-implemented) with local community members and organisations, the local public health service, local Aboriginal Community Controlled Health Service, and an on-site University Department of Rural Health. The purpose of this service was to deliver a holistic healthy aging service that supports individuals to age well in community, provides support to carers and families, and increases community capacity improve health and wellbeing for the whole community. Aim: This study aims to explore the perspectives of health professionals, community organisations and allied health university students on the integration of care provided by the service. Methods: Structured interviews were conducted with 18 participants who were involved in either the delivery, participation or support of the service. Deductive thematic analysis utilised theory-based codes derived from an integrated care theory. Each of the nine pillars of integrated care represented a theme that was further sorted into micro, meso, and macro system-level enablers and barriers to service delivery. Results: Macro themes broadly identified a lack of a shared vision and values between organisations. The lack of integration, including fragmented data systems, at the macro level impacted on meso and micro level integration of care. The culture of siloed, discipline focused service models was a meso barrier impacting on micro level interprofessional working. The most frequently discussed micro level enabler to the success of the service was the collaborative relationships between Indigenous and non-Indigenous staff and students. Lessons learned: Culturally responsive practice principles are an enabler to integrated care in First Nation communities. An integrated care approach can help define rural and remote allied health, primary care service models that address health outcomes from individual to population level needs. Conclusions: These results reinforce that services striving to provide integrated care require organisational scaffolding to embed process that reflect integration of care.

Energy storage (batteries, capacitors) and conversion (solar cells) systems are increasing demand for vehicles, mobile electronics, and other areas as alternatives to fossil fuels.These systems are complex and multi-component with many materials and interfaces that are difficult to handle and characterize. To optimize materials properties and improve battery lifetimes, there is a pressing need for physicochemical characterization approaches with air-free handling capabilities, high spatial resolution, the ability to analyze buried interfaces without damaging the chemistry, and the need to bridge the gap by in situ and operando surface analysis. Developments in X-ray Photoelectron Spectrometers (XPS) open up new capabilities to address these challenges. In this talk, I will discuss how we can overcome obstacles in analyzing battery materials using: Inert environment transfer vessel: This allows for handling battery materials in an air-free environment, which is essential for preventing oxidation and other degradation reactions. Microprobe X-ray source with <5 µm spatial resolution: This provides high spatial resolution for analyzing small areas of interest, such as SEI, dendrites and other features. Hard X-ray source and cluster ion gun source: These allow for the analysis of buried interfaces not accessible by conventional soft X-ray XPS. In situ energy gap measurements: These allow for the study of the changes in the electronic structure of battery materials as they are cycled, which can provide insights into the mechanisms of charge storage and discharge. Operando XPS experiments: These allow for the study of the changes in the surface structure of battery materials as they are operating, which can provide insights into the factors that affect their performance. Figure 1

Semiconductor interface investigation via analytical characterization represents a major focus for Failure Analysis and Process Characterization Teams. Investigation can be performed via destructive techniques through depth profiling until reaching the interface while collecting matrix and impurity distributions as a function of depth and also via nondestructive techniques which preserves information about the interface. Interface characterization involves the deployment of Failure Analysis resources, employing advance imaging and materials characterization techniques like TEM (transmission electron microscopy), SEM (Scanning Electron Microscopy), DSIMS (dynamic secondary mass spectrometry), TOFSIMS (time of flight secondary ion mass spectrometry), Auger, XRF (X-Ray Fluorescence), and XPS (X-ray Photoelectron Spectroscopy). As first exampled in the case study detailed in this paper, increased aluminum resistance was caused by oxidation of aluminum metal while in a cooling chamber prior to barrier layer deposition due to chamber lid atmospheric leaks. High resistivity interconnect issues can be related to interface quality and diminish product performance up to complete failure. Typical methods like cross section analysis via TEM and SEM did not reveal any abnormality. This prompted further investigation where innovative depth profiling methods of DSIMS / TOFSIMS to the encapsulated interface was used, highlighting the presence of oxidized aluminum metal. In another example, analysis was performed nondestructively utilizing a newly developed High Energy HAXPS mode, allowing for the successful characterization of interfaces and high electron mobility transistors where layer interaction is vital.

Journal Article Analysis of Thin Films and Buried Interfaces by Soft and Hard X-ray Photoemission Get access Kateryna Artyushkova, Kateryna Artyushkova Physical Electronics Inc, Chanhassen, MN, United States Corresponding author: kartyushkova@phi.com Search for other works by this author on: Oxford Academic Google Scholar Jennifer Mann, Jennifer Mann Physical Electronics Inc, Chanhassen, MN, United States Search for other works by this author on: Oxford Academic Google Scholar Sarah Zaccarine Sarah Zaccarine Physical Electronics Inc, Chanhassen, MN, United States Search for other works by this author on: Oxford Academic Google Scholar Microscopy and Microanalysis, Volume 29, Issue Supplement_1, 1 August 2023, Page 768, https://doi.org/10.1093/micmic/ozad067.379 Published: 22 July 2023

The demand and complexity of the health needs of older people is growing. Traditionally siloed, condition-centric care is no longer appropriate. It is costly to the Australian health system and life-threatening to the individual. In parallel to demographic change is increasing global awareness of the impact of social, behavioural, and environmental factors on health outcomes. Although significant when not addressed, the amenable nature of many personal contextual factors is an opportunity to improve health and quality of life. A move away from reactive, episodic models of health care delivery towards patient focussed integrated care is required to meet the changing demands of an aging population. This forum article provides a reflection on the current state of integration for older people with complex needs through the lens of a local community facing model: OPEN ARCH. Australia still has some way to go to establishing system level enablers for an integrated approach to care. However, the OPEN ARCH experience furthers the evidence for ground-up approaches of integrated care that can meet the increasing demand and complexity of older people's needs.

The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 2.913 (2021 JCR, received in June 2022)The IJIC 20th Anniversary Issue was published in 2021.

Objective:To assess the cost of implementation, delivery and cost-effectiveness (CE) of a flagship community-based integrated care model (OPEN ARCH) against the usual primary care.Design:A 9-month stepped-wedge cluster-randomised trial.Setting and participants:Community-dwelling older adults with chronic conditions and complex care needs were recruited from primary care (14 general practices) in Far North Queensland, Australia.Methods:Costs and outcomes were measured at 3-month windows from the healthcare system and patient's out-of-pocket perspectives for the analysis. Outcomes included functional status (Functional Independence Measure (FIM)) and health-related quality of life (EQ-5D-3L and AQoL-8D). Bayesian CE analysis with 10 000 Monte Carlo simulations was performed using the BCEA package in R (V.3.6.1).Results:The OPEN ARCH model of care had an average cost of $A1354 per participant. The average age of participants was 81, and 55% of the cohort were men. Within-trial multilevel regression models adjusted for time, general practitioner cluster and baseline confounders showed no significant differences in costs, resource use or effect measures regardless of the analytical perspective. Probabilistic sensitivity analysis with 10 000 simulations showed that OPEN ARCH could be recommended over usual care for improving functional independence at a willing to pay above $A600 (US$440) per improvement of one point on the FIM Scale and for avoiding or reducing inpatient stay for any willingness-to-pay threshold up to $A50 000 (US$36 500).Conclusions and implications:OPEN ARCH was associated with a favourable Bayesian CE profile in improving functional status and dependency levels, avoiding or reducing inpatient stay compared with usual primary care in the Australian context.Trial registration number:ACTRN12617000198325.

The aim of this study was to present the health and social characteristics of community-dwelling older people within the Cairns region who were identified by their GP as having complex care needs. This paper reports the subanalysis of baseline data from the Older Persons Enablement and Rehabilitation (OPEN ARCH) stepped wedge randomised controlled trial of an integrated model of care for community-dwelling older people. Data were analysed at the level of the participant and the level of the participant cluster (group of participants from the one GP). Median quality of life, as assessed by the EQ-5D, was higher for females than males (80 vs 70 respectively; P=0.05) and for people living alone than living with family (80 vs 60 respectively; P=0.0940). There was greater functional independence among non-Indigenous than Indigenous participants (median Functional Independence Measure scores of 122 vs 115 respectively; P=0.0937) and the incidence rate (95% confidence intervals) of presentation to the emergency department was sevenfold higher for Indigenous than non-Indigenous participants (11.47 (5.93-20.03) vs 1.65 (0.79-3.04) per 1000 person days respectively). Finally, 61.3% of participants required support to remain living in the community and 44% accessed allied health, with podiatry the most common intervention. The findings indicate that previous hospital utilisation is not a consistent indicator of complexity. Multimorbidity, cultural context and the living and caring situation are considered as matters of complexity, yet variation exists at the participant level.

Background An ageing population and rise in multi-morbidity increase hospital utilisation and acuity of presentation, particularly amongst the older person with complex needs. Health systems must reorient towards preventative and co-ordinated care to reduce hospital demand and achieve positive and fiscally responsible client outcomes. Integrated care models can improve outcomes for the older person by aligning primary practice with the specialist health care and social services required to manage complex needs. This paper describes the impact of a community facing program that integrates care at the primary-secondary interface on the rate of Emergency Department (ED) presentation and hospital separations amongst older people with complex needs. Methods The OPEN ARCH study is a multicentre randomised controlled trial with a stepped wedge cluster design. General practitioners (GPs; n=14) are considered ‘clusters’ each comprising a mixed number of participants. 80 community dwelling persons over 70 years of age if non-Indigenous and over 50 years of age if Indigenous were included in the study. Clusters were randomly assigned to the time at which they would commence the OPEN ARCH intervention, with intervention periods of 3, 6 and 9 months duration. Each participant was its own control. ED presentations and hospital separations were collected from Queensland Health Casemix data and analysed with multilevel mixed-effects Poisson regression modelling to determine the effectiveness of the OPEN ARCH intervention. Data were analysed at the cluster and participant levels. Results The OPEN ARCH intervention was found to not make a statistically significant difference to ED presentations or hospitalisations. However, a stabilising of ED presentations and trend toward lower hospitalisation rates over time was observed. Conclusions While this study detected no statistically significant different change in ED presentations or hospital separations, a plateauing of ED presentation and hospitalisation ratesis a clinically significant finding for older persons with complex needs. Multi-sectoral integrated programs of care require an adequate preparation period and sufficient duration of intervention for effectiveness to be measured. Trial registration The OPEN ARCH study received ethical approval from the Far North Queensland Human Research Ethic Committee, HREC/17/QCH/104 – 1174 and is registered on the Australian and New Zealand Trials Registry, ACTRN12617000198325p.

Introduction (comprising context and problem statement): Older persons with complex needs experience frequent and repeated health care interactions, have longer hospital stays and are more likely to require formal supports to continue living at home. They are also  vulnerable to system complexities which can be costly to the health system and life threatening to the individual.  To avoid preventable hospitalisation and premature institutionalisation, these older people  require comprehensive, patient-focussed medical and social supports Short description of practice change implemented: OPEN ARCH (Older Persons Enablement and Rehabilitation for Complex Health Needs) is a co-designed integrated care program delivered at the primary-secondary interface. OPEN ARCH provides preventative focussed multidisciplinary comprehensive geriatric assessment, and social care coordination for older persons at risk of functional decline or hospitalisation. Aim and theory of change: OPEN ARCH aims to improve access to comprehensive care for the older person that is otherwise only available through hospital admission.  Evidence suggests that engagement with primary care and improved access to specialist health care and preparatory social supports early in the trajectory of the person’s illness can prevent avoidable hospitalisation and assist the older person to stay living at home for longer.  Targeted population and stakeholders: Older persons with complex needs who are at risk of rapid functional decline or hospitalisation are eligible for referral to OPEN ARCH.  OPEN ARCH is a Queensland Health service with formal service partnerships with primary care practitioners in Far North Queensland.  Timeline: OPEN ARCH commenced in November 2017 and continues to provide services to older persons across the Cairns region. Highlights (innovation, Impact and outcomes):  OPEN ARCH is an Australian-first model of care that combines specialist outreach, care coordination and primary care partnership for the provision of comprehensive care for the older person. Comments on sustainability:  The financial sustainability of OPEN ARCH is leveraged from the revenue opportunities for primary and specialist care provision.  While sustainability of care coordination is challenging in the Australian health system, the OPEN ARCH model is sustained through the primary-secondary partnership and collaboration with social care agencies. Comments on transferability: Primary-secondary collaboration and the establishment of common objectives of integration are essential for successful geographic or demographic transferability. Conclusions (comprising key findings):  Preliminary results indicate that OPEN ARCH has a positive impact on quality of life for the older person and is a model acceptable to the client and other key stakeholders. Shared medical records, case conferencing and complementary provision of specialist-generalist services is supportive of a patient focussed model of care. Discussions: The OPEN ARCH model of care achieved integration through the consideration of many core components of integrated care, namely: a targeted approach for older persons with complex needs; utilisation of primary care financial incentives; shared medical records; a collaborative culture; effective leadership. Lessons learned: Vertical integration within the health system is achievable yet sectoral integration beyond a care co-ordination model is challenging.

There is worldwide recognition of the need to redesign health service delivery with a focus on strengthening primary health care and aligning health and social care through integrated models. A defining feature of integrated models is improved patient and carer experience of care. This study explored the experiences of older people and their carers enrolled in a unique model of integrated care that provides a specialist geriatric intervention in the primary care setting for older adults with complex needs in Far North Queensland. A qualitative exploratory descriptive design using semistructured interviews was used to address the study aims. Seventeen older people and nine carers took part in the study. Data were analysed inductively, guided by the principles of thematic analysis. Three themes emerged: getting by; achieving positive change; and improving and maintaining the OPEN ARCH (Older Persons ENablement And Rehabilitation for Complex Health conditions) approach. The findings indicate that enablement models of integration can be successful in activating positive change towards independence for the older person with complex needs. Understanding patients’ and carers’ experiences is essential to comprehensive service evaluation.

The greater information depth provided in hard X-ray photoelectron spectroscopy (HAXPES) enables nondestructive analyses of the chemistry and electronic structure of buried interfaces. Moreover, for industrially relevant elements like Al, Si, and Ti, the combined access to the Al 1s, Si 1s, or Ti 1s photoelectron line and its associated Al KLL, Si KLL, or Ti KLL Auger transition, as required for local chemical state analysis on the basis of the Auger parameter, is only possible with hard X-rays. Until now, such photoemission studies were only possible at synchrotron facilities. Recently, however, the first commercial XPS/HAXPES systems, equipped with both soft and hard X-ray sources, have entered the market, providing unique opportunities for monitoring the local chemical state of all constituent ions in functional oxides at different probing depths, in a routine laboratory environment. Bulk-sensitive shallow core levels can be excited using either the hard or soft X-ray source, whereas more surface-sensitive deep core-level photoelectron lines and associated Auger transitions can be measured using the hard X-ray source. As demonstrated for thin Al2O3, SiO2, and TiO2 films, the local chemical state of the constituting ions in the oxide may even be probed at near-constant probing depth by careful selection of sets of photoelectron and Auger lines, as excited with the combined soft and hard X-ray sources. We highlight the potential of lab-based HAXPES for the research on functional oxides and also discuss relevant technical details regarding the calibration of the kinetic binding energy scale.

Optimal care of community-dwelling older Australians with complex needs is a national imperative. Suboptimal care that is reactive, episodic and fragmented, is costly to the health system, can be life threatening to the older person and produces unsustainable carer demands. Health outcomes would be improved if services (health and social) are aligned towards community-based, comprehensive and preventative care. Integrated care is person-focussed in outlook and defies a condition-centric approach to healthcare delivery. Integration is a means to support primary care, with the volume and complexity of patient needs arising from an ageing population. Older Persons Enablement and Rehabilitation for Complex Health Conditions (OPEN ARCH) is a targeted model of care that improves access to specialist assessment and comprehensive care for older persons at risk of functional decline, hospitalisation or institutionalised care. OPEN ARCH was developed with primary care as the central integrating function and is built on four values of quality care: preventative health care provided closer to home; alignment of specialist and generalist care; care coordination and enablement; and primary care capacity building. Through vertical integration at the primary-secondary interface, OPEN ARCH cannot only improve the quality of care for clients, but improves the capacity of primary care to meet the needs of this population.

X-ray Photoelectron Spectroscopy (XPS) is a widely used surface analysis technique with many well established industrial and research applications. The surface sensitivity (top 5-10 nm) of XPS and its ability to provide short-range chemical bonding information make the technique extremely popular in materials characterization and failure analysis laboratories. While its surface sensitivity is an important attribute, in some cases, the depth of analysis of XPS is not sufficient to analyze buried interfaces without first sputter etching the sample surface. However, sputter etching can often lead to alterations of the true surface chemistry. An alternative to sputter etching the sample is Hard X-ray Photoelectron Spectroscopy (HAXPES), available at some synchrotron facilities. HAXPES utilizes X-rays typically defined as having energies greater than 5 keV. By increasing the photon energy of the X-ray source, the mean free path of photoelectrons is increased, resulting in an increased information depth obtained from the sample. Depending on the energy used, these hard X-rays can provide depths of analysis three or more times than that of soft x-rays used on conventional XPS systems. HAXPES measurements are, therefore, more sensitive to the bulk, and contributions from the surface are minimized.1,2 This presentation will describe a laboratory-based instrument, the PHI Quantes, equipped with two scanning microprobe monochromated X-ray sources, Al Kα (1486.6 eV) and Cr Kα (5414.9 eV), thus enabling both traditional XPS and HAXPES experiments in the same instrument. Combining both soft and hard X-ray analyses, we can gain an even better understanding of composition with depth and information at buried interfaces. References Kobayashi, K. Hard X-ray photoemission spectroscopy, Nucl. Instr. Meth. Phys. Res. A 2009, 601, 32-47. Fadley, C.S. Hard X-ray Photoemission: An Overview and Future Perspective. In Hard X-ray Photoelectron Spectroscopy (HAXPS); Woicik, J. C., Ed; Springer: Switzerland 2016.

Combined chemical analyses of both the surface and bulk of industrial catalysts is a significant challenge, because all microanalysis methods reveal either the surface or the bulk properties but not both. We demonstrate the combined use of hard and soft X‐ray photoelectron spectroscopy (XPS) as a powerful, practical, and nondestructive tool to quantitatively analyze the chemical composition at the surfaces (~1 nm) and subsurfaces/bulk (~10 nm) for catalysts. The surface‐bulk differentiation is achieved via an exchangeable anode system, where the Al (Kα, 1486.6 eV) and Cr (Kα, 5414.7 eV) for the XPS and hard X‐ray photoelectron spectroscopy (HAXPES) analyses, respectively, are interchanged without affecting the X‐ray beam position on the sample. As an archetypical catalyst, we study the perovskite‐type material La0.30Sr0.55Ti0.95Ni0.05O3‐δ (LSTNO), which has differing chemical compositions at the surface and subsurface after reduction and oxidation reactions. We look at the relative changes in surface composition, which minimizes the error stemming from the differing relative sensitivity factors in the oxidized and reduced states. The HAXPES‐XPS analysis indirectly confirms the well‐known exsolution and formation of Ni nanoparticles on the surface upon reduction though following changes of Ni concentration at the surface. However, the XPS‐HAXPES analysis demonstrates an increase in not only the Ni but also the Sr, which corroborates the reorganization within the perovskite lattice upon reduction. The XPS‐measured intensities decrease for all the accessible peaks (La 3d, Sr 3d, lattice O 1s, and Ti 2p), which is attributed to the photon diffusion by the surface Ni nanoparticles.

Heterojunctions underpin the design and performance of virtually all devices based on conventional semiconductors. While metal halide perovskites have received intense attention for applications in photoconversion and optoelectronics, these devices are often hybrid, containing interfaces between the perovskite and metal oxide or organic semiconductor layers. Heterojunctions between two perovskite layers could enable new paradigms in device engineering, but to date, their formation has remained limited due to difficulty in fabricating multilayers and facile ion diffusion across interfaces. Here, sequential solution and vapor processing is used to successfully fabricate perovskite/perovskite heterojunctions comprising three-dimensional APbX3/CH3NH3SnX3 [A = CH(NH2)2, CH3NH3, or Cs; X = I or Br] layers. Heterojunction stability is investigated leading to the identification of two pairings that are stable for >1500 h at room temperature. By probing mixing as a function of composition and grain size, we propose general design rules for the realization of stable perovskite/perovskite heterojunctions.

INTRODUCTION:The burden of stroke for Aboriginal and Torres Strait Islander peoples in Australia is significant. The National Stroke Foundation has identified that Aboriginal and Torres Strait Islander people are more likely to have a stroke at a younger age than the non-Indigenous population and are twice as likely for stroke to result in death, and that those Aboriginal and Torres Strait Islander people living in rural and remote areas are less likely to have access to an acute stroke unit. The only acute stroke unit in Far North Queensland treats six times more Aboriginal and Torres Strait Islander patients than the Queensland average, a large proportion of whom reside in the rural and remote communities of the Cape and Torres Strait. This article describes part of the qualitative phase of a project titled 'Culturally appropriate stroke services for Aboriginal and Torres Strait Islander people', received Closing the Gap funding to identify the needs of Aboriginal and Torres Strait Islander stroke survivors in Far North Queensland and establish a model of care that is responsive to these needs. METHOD:Data were collected from 24 stroke survivors, 10 carers and 70 stakeholders through surveys. The surveys incorporated open-ended questions and were administered through face to face interviews with participants from across 18 diverse Aboriginal and Torres Strait Islander communities within Far North Queensland. Guided by the principles of thematic analysis the data were coded, categories created and themes and subthemes identified. RESULTS:This study emphasises the need for an inclusive coordinated and culturally responsive approach to Aboriginal and Torres Strait Islander stroke care that values the role of the client, their family and community. The Aboriginal and Torres Strait Islander liaison officer has a pivotal role within the multidisciplinary team. Resources specific to the language, literacy and cultural needs of Aboriginal and Torres Strait Islander stroke survivors are required as is advocacy for the availability and use of Aboriginal and Torres Strait Islander language interpreters. Aboriginal and Torres Strait Islander stroke survivors have limited opportunity to fulfil their rehabilitation potential after hospital discharge. CONCLUSION:An integrated patient centred model of care that spans the care continuum and places value on an extended role for the Aboriginal and Torres Strait Islander health worker workforce is indicated, as is an increased utilisation of allied health and specialist follow-up close to home.

The greater information depth provided in Hard X-ray Photoelectron Spectroscopy (HAXPES) enables non-destructive analyses of the chemistry and electronic structure of buried interfaces. Moreover, for industrially relevant elements like Al, Si and Ti, the combined access to the Al 1s, Si 1s or Ti 1s photoelectron line and its associated Al KLL, Si KLL or Ti KLL Auger transition, as required for local chemical state analysis on the basis of the Auger parameter, is only possible with hard X-rays. Until now, such photoemission studies were only possible at synchrotron facilities. Recently however, the first commercial XPS/HAXPES systems, equipped with both soft and hard X-ray sources, have entered the market, providing unique opportunities for monitoring the local chemical state of all constituent ions in functional oxides at different probing depths, in a routine laboratory environment. Bulk-sensitive shallow core-levels can be excited using either the hard or soft X-ray source, whereas more surface-sensitive deep core-level photoelectron lines and associated Auger transitions can be measured using the hard X-ray source. As demonstrated for thin Al2O3, SiO2 and TiO2 films, the local chemical state of the constituting ions in the oxide may even be probed at near constant probing depth by careful selection of sets of photoelectron and Auger lines, as excited with the combined soft and hard X-ray sources. We highlight the potential of lab-based HAXPES for the research on functional oxides and also discuss relevant technical details regarding the calibration of the kinetic binding energy scale.

Photoelectron imaging spectra of three alkenoxide radical anions (3-buten-1-oxide, 3-buten-2-oxide, and 2-propenoxide) are presented and analyzed with supporting results of density functional theory calculations. In all spectra, intense detachment features are observed at approximately 2 eV electron binding energy, which is similar to the electron affinities of saturated neutral alkoxy radicals [Ramond et al., J. Chem. Phys. 112, 1158 (2000)]. Photoelectron angular distributions suggest the presence of several overlapping transitions which are assigned to the X̃ and à states of multiple energetically competitive conformers. The term energy of the à state of the 2-propenoxy radical, 0.17 eV, is higher than that of 3-buten-2-oxy (0.13 eV) and 3-buten-1-oxy (0.05 eV) radicals. Comparing the butenoxy radicals, we infer that stronger interactions between the non-bonding O 2p orbitals and the π bond increase the splitting between the ground and the first excited state in the 3-buten-2-oxy radical relative to the 3-buten-1-oxy radical.

Purpose Integrated care is gaining popularity in Australian public policy as an acceptable means to address the needs of the unwell aged. The purpose of this paper is to investigate contemporary models of integrated care for community dwelling older persons in Australia and discuss how public policy has been interpreted at the service delivery level to improve the quality of care for the older person. Design/methodology/approach A scoping review was conducted for peer-reviewed and grey literature on integrated care for the older person in Australia. Publications from 2007 to present that described community-based enablement models were included. Findings Care co-ordination is popular in assisting the older person to bridge the gap between existing, disparate health and social care services. The role of primary care is respected but communication with the general practitioner and introduction of new roles into an existing system is challenging. Older persons value the role of the care co-ordinator and while robust model evaluation is rare, there is evidence of integrated care reducing emergency department presentations and stabilising quality of life of participants. Technology is an underutilised facilitator of integration in Australia. Innovative funding solutions and a long-term commitment to health system redesign is required for integrated care to extend beyond care co-ordination. Originality/value This scoping review summarises the contemporary evidence base for integrated care for the community dwelling older person in Australia and proposes the barriers and enablers for consideration of implementation of any such model within this health system.