Book Review: Jamie Peck and Kevin Ward (eds) City of Revolution: Restructuring Manchester

Manchester, Manchester University Press, 2002, xvi + 256 pp., £14.99 (pbk), ISBN 0719058880

Multivariate Markov Process Models for the transmission of methicillin-resistant Staphylococcus Aureus in a hospital ward

Methicillin-resistant Staphylococcus Aureus (MRSA) is a pathogen that continues to be of major concern in hospitals. We develop models and computational schemes based on observed weekly incidence data to estimate MRSA transmission parameters. We extend the deterministic model of McBryde, Pettitt, and McElwain (2007, Journal of Theoretical Biology 245, 470–481) involving an underlying population of MRSA colonized patients and health-care workers that describes, among other processes, transmission between uncolonized patients and colonized health-care workers and vice versa. We develop new bivariate and trivariate Markov models to include incidence so that estimated transmission rates can be based directly on new colonizations rather than indirectly on prevalence. Imperfect sensitivity of pathogen detection is modeled using a hidden Markov process. The advantages of our approach include (i) a discrete valued assumption for the number of colonized health-care workers, (ii) two transmission parameters can be incorporated into the likelihood, (iii) the likelihood depends on the number of new cases to improve precision of inference, (iv) individual patient records are not required, and (v) the possibility of imperfect detection of colonization is incorporated. We compare our approach with that used by McBryde et al. (2007) based on an approximation that eliminates the health-care workers from the model, uses Markov chain Monte Carlo and individual patient data. We apply these models to MRSA colonization data collected in a small intensive care unit at the Princess Alexandra Hospital, Brisbane, Australia.

The last post? Tracking the Australasian to Aussie Post, 1864-2002

Aussie Post, the flagship of ocker Australiana, folded in January 2002. Post began life as the Australasian, a middlebrow magazine steeped in a nineteenth century civics of stable citizenship with a modicum of diversionary leisure. The transformation began when the Australasian became Australasian Post in 1946 under George Johnston's brief 15-week editorship. Johnston's idealistic vision of Post as a voice of post-war Australian modernity was soon overtaken by commercial imperatives as Post's identity wavered between its civic antecedents and a new low-brow populism, a niche it had finally settled into by the mid-1950s. This tension between staid civics and risqué populism shaped the magazine's long evolution into its final realisation of the pictorial general interest genre. This paper, based on a close examination of the magazines themselves, tracks Post's generic evolution and focuses on the struggle to redefine the magazine’s identity during the post-war period when the axis of Australian identity was reluctantly shifting from the staid traditions of Rule Britannia to the flashy modernity of Pax Americana.

Not for profit income tax exemption : is there a hole in the bucket, dear Henry?

Australia’s Future Tax System Review, headed by the then head of the Australian Treasury, and the Productivity Commission’s Research Report on the not for profit sector, both examined the state of tax concessions to Australia’s not for profit sector in the light of the High Court’s decision in Commissioner of Taxation v Word Investments Ltd. Despite being unable to quantify with any certainty the pre- or post-Word Investments cost of the tax concessions, both Reports indicated their support for continuation of the income tax exemption. However, the government acted in the 2011 Budget to target the not for profit income tax concessions more precisely, mainly on competitive neutrality grounds. This article examines the income tax exemption by applying the five taxation design principles, proposed in the Australia’s Future Tax System Review, for assessing tax expenditure. The conclusion is that the exemptions can be justified and, further, that a rationale for the exemption can be consistent with the reasoning in the Word Investments case.

Submission to the Legal Affairs and Community Safety Committee - Youth Justice (Boot Camp Orders) and Other Legislation Amendment Bill 2012

This submission addresses the Youth Justice (Boot Camp Orders) and Other Legislation Amendment Bill 2012 which has as its objectives (1) the introduction of a Boot Camp Order as an option instead of detention for young offenders and (2) the removal of the option of court referred youth justice conferencing for young offenders. As members of the QUT Faculty of Law Centre for Crime and Justice we welcome the invitation to participate in the discussion of these issues which are critically important to the Queensland community at large but especially to our young people.

Colour and Camp Bring Shakespeare’s As You Like It to Life

As You Like It By Shakespeare. La Boite Theatre Company, Brisbane, February 24. DURING the past three years, La Boite Theatre Company has started each season with a modern adaptation of a Shakespearean favourite. This time, director David Bertold's choice is not a tragedy but As You Like It, a comedy about love's twists and turns in which a strong female figure, Rosalind, takes the leading role...

The impact of surgical ward nurses practicing respiratory assessment on positive patient outcomes

Objective: A literature review to examine the incorporation of respiratory assessment into everyday surgical nursing practice; possible barriers to this; and the relationship to patient outcomes. Primary argument: Escalating demands on intensive care beds have led to highly dependent patients being cared for in general surgical ward areas. This change in patient demographics has meant the knowledge and skills required of registered nurses in these areas has expanded exponentially. The literature supported the notion that postoperative monitoring of vital signs should include the fundamental assessment of respiratory rate; depth and rhythm; work of breathing; use of accessory muscles and symmetrical chest movement; as well as auscultation of lung fields using a stethoscope. Early intervention in response to changes in a patient's respiratory health status impacts positively on patient health outcomes. Substantial support exists for the contention that technologically adept nurses who also possess competent respiratory assessment skills make a difference to respiratory care. Conclusions: Sub-clinical respiratory problems have been demonstrated to contribute to adverse events. There is a paucity of research knowledge as to whether respiratory education programs and associated inservice make a difference to nursing clinical practice. Similarly, the implications for associated respiratory educational needs are not well documented, nor has a research base been sufficiently developed to guide nursing practice. Further research has the potential to influence the future role and function of the registered nurse by determining the importance of respiratory education programs on post-operative patient outcomes.

Noise levels in a General Surgical Ward : a descriptive study

Aims and objectives.  This study was undertaken to measure and analyse levels of acoustic noise in a General Surgical Ward. Method.  Measurements were undertaken using the Norsonic 116 sound level meter (SLM) recording noise levels in the internationally agreed ‘A’ weighted scale. Noise level data and observational data as to the number of staff present were obtained and recorded at 5-min intervals over three consecutive days. Results.  Results of noise level analysis indicated that mean noise level within this clinical area was 42.28 dB with acute spikes reaching 70 dB(A). The lowest noise level attained was that of 36 dB(A) during the period midnight to 7 a.m. Non-parametric testing, using Spearman's Rho (two-tailed), found a positive relationship between the number of staff present and the level of noise recorded, indicating that the presence of hospital personnel strongly influences the level of noise within this area. Relevance to clinical practice.  Whilst the results of this may seem self-evident in many respects the problems of excessive noise production and the exposure to it for patients, hospital personnel and relatives alike continues unabated. What must be of concern is the psychophysiological effects excessive noise exposure has on individuals, for example, decreased wound healing, sleep deprivation and cardiovascular stimulation.

Measuring multidisciplinary team effectiveness in a ward-based healthcare setting : development of the Team Functioning Assessment Tool

Nontechnical skills relating to team functioning are vital to the effective delivery of patient care and safety. In this study, we develop a reliable behavioral marker tool for assessing nontechnical skills that are critical to the success of ward-based multidisciplinary healthcare teams. The Team Functioning Assessment Tool (TFAT) was developed and refined using a literature review, focus groups, card-sorting exercise, field observations, and final questionnaire evaluation and refinement process. Results demonstrated that Clinical Planning, Executive Tasks, and Team Relations are important facets of effective multidisciplinary healthcare team functioning. The TFAT was also shown to yield acceptable inter-rater agreement.

Measuring ward-based multidisciplinary healthcare team functioning : a validation study of the Team Functioning Assessment Tool (TFAT)

The team functioning assessment tool (TFAT) has been shown to be a reliable behavioral marker tool for assessing nontechnical skills that are critical to the success of ward-based healthcare teams. This paper aims to refine and shorten the length of the TFAT to improve usability, and establish its reliability and construct validity. Psychometric testing based on 110 multidisciplinary healthcare teams demonstrated that the TFAT is a reliable and valid tool for measuring team members’ nontechnical skills in regards to Clinical Planning, Executive Tasks, and Team Functioning. Providing support for concurrent validity, high TFAT ratings were predicted by low levels of organizational constraints and high levels of group potency. There was also partial support for the negative relationships between time pressure, leadership ambiguity, and TFAT ratings. The paper provides a discussion on the applicability of the tool for assessing multidisciplinary healthcare team functioning in the context of improving team effectiveness and patient safety for ward-based hospital teams.