Does the use of store-and-forward telehealth systems improve outcomes for clinicians managing diabetic foot ulcers? : A pilot study

Diabetic foot ulcers are one of the most hospitalised diabetes complications and contribute to many leg amputations. Trained diabetic foot teams and specialists managing diabetic foot ulcers have demonstrated reductions in amputations and hospitalisation by up to 90%. Few such teams exist in Australia. Thus, access is limited for all geographical populations and may somewhat explain the high rates of hospitalisation. Aim: This pilot study aims to analyse if local clinicians managing diabetic foot complications report improved access to diabetic foot specialists and outcomes with the introduction of a telehealth store-and-forward system. Method: A store-and-forward telehealth system was implemented in six different Queensland locations between August 2009 and February 2010. Sites were offered ad hoc and/or fortnightly telehealth access to a diabetic foot speciality service. A survey was sent six months following commencement of the trial to the 14 eligible clinicians involved in the trial to gauge clinical perception of the telehealth system. Results: Eight participants returned the surveys. The majority of responding clinicians reported that the telehealth system was easy to use (100%), improved their access to diabetic foot speciality services (75%), improved upskilling of local diabetes service staff (100%), and improved patient outcomes (100%). Conclusion: This pilot study suggests that clinicians found the use of a telehealth store-and-forward system very useful in improving access to speciality services, clinical skills and patient outcomes. This study supports the recommendation that telehealth systems should be made available for diabetic foot ulcer management.

Augmenting public participation : enhancing planning outcomes through the use of social media and web 2.0

Social media and web 2.0 tools offer opportunities to devise novel participation strategies that can engage previously difficult to reach as well as new segments of society in urban planning. This paper examines participatory planning in the four local government areas of Brisbane City Council, Gold Coast City Council, Redland City Council, and Toowoomba Regional Council, all situated in South East Queensland, Australia. The paper discusses how social media and web 2.0 tools can deliver a more engaging planning experience to citizens, and investigates local government’s current use and receptiveness to social media tools for plan making and community engagement. The study’s research informed the development of criteria to assess the level of participation reached through the current use of social media and web 2.0 in the four local government areas. This resulted in an adaptation of the International Association for Public Participation (IAP2) Toolbox to integrate these new tools which is being presented to encourage further discussion and evaluation by planning professionals.

Finding your research voice : the application of bibliometrics as an analytic literature tool on the pedagogic field of higher education

This paper documents the use of bibliometrics as a methodology to bring forth a structured, systematic and rigorous way to analyse and evaluate a range of literature. When starting out and reading broadly for my doctoral studies, one article by Trigwell and Prosser (1996b) led me to reflect about my level of comprehension as the content, concepts and methodology did not resonate with my epistemology. A disconnection between our paradigms emerged. Further reading unveiled the work by Doyle (1987) who categorised research in teaching and teacher education by three main areas: teacher characteristics, methods research and teacher behaviour. My growing concerns that there were gaps in the knowledge also exposed the difficulties in documenting said gaps. As an early researcher who required support to locate myself in the field and to find my research voice, I identified bibliometrics (Budd, 1988; Yeoh & Kaur, 2007) as an appropriate methodology to add value and rigour in three ways. Firstly, the application of bibliometrics to analyse articles is systematic, builds a picture from the characteristics of the literature, and offers a way to elicit themes within the categories. Secondly, by systematic analysis there is occasion to identify gaps within the body of work, limitations in methodology or areas in need of further research. Finally, extension and adaptation of the bibliometrics methodology, beyond citation or content analysis, to investigate the merit of methodology, participants and instruments as a determinant for research worth allowed the researcher to build confidence and contribute new knowledge to the field. Therefore, this paper frames research in the pedagogic field of Higher Education through teacher characteristics, methods research and teacher behaviour, visually represents the literature analysis and locates my research self within methods research. Through my research voice I will present the bibliometrics methodology, the outcomes and document the landscape of pedagogy in the field of Higher Education.

Collaboration and competition on a Wiki : the praxis of online social learning to improve academic writing and research in under-graduate students

The number of internet users in Australia has been steadily increasing, with over 10.9 million people currently subscribed to an internet provider (ABS, 2011). Over the past year, the most avid users of the Internet were 15 – 24 year olds, with approximately 95% accessing the internet on a regular basis (ABS, Social Trends, 2011). While the internet, in particularly Web 2.0, has been described as fundamental to higher education students, social and leisure internet tools are also increasingly being used by these students to generate and maintain their social and professional networks and interactions (Duffy & Bruns, 2006). Rapid technological advancements have enabled greater and faster access to information for learning and education (Hemmi et al, 2009; Glassman & Kang, 2011). As such, we sought to integrate interactive, online social media into the assessment profile of a Public Health undergraduate cohort at the Queensland University of Technology (QUT). The aim of this exercise was to engage undergraduate students to both develop and showcase their research on a range of complex, contemporary health issues within the online forum of Wikispaces for review and critique by their peers. We applied Bandura’s Social Learning Theory (SLT) to analyse the interactive processes from which students developed deeper and more sustained learning, and via which their overall academic writing standards were enriched. This paper outlines the assessment task, and the students’ feedback on their learning outcomes in relation to the Attentional, Retentional, Motor Reproduction, and Motivational Processes outlined by Bandura in SLT. We conceptualise the findings in a theoretical model, and discuss the implications for this approach within the broader tertiary environment.

Six rules for practice-led research

Recent experience of practice-led postgraduate supervision has prompted me to conclude that the practice-led research method, as it is currently construed, produces good outcomes, especially in permitting practitioners in the creative arts, design and media into the research framework, but at the same time it also generates certain recurring difficulties. What are these difficulties? Practice-led candidates tend to rely on a narrow range of formulations with the result that they assume: (i) the innovative nature of practice-led research; (ii) that its novelty is based in opposition to other research methods; (iii) that practice is intrinsically research, often leading to tautological formulations; (iv) the hyper-self-reflexive nature of practice-led research. This set of guidelines was composed in order to circumvent the shortcomings that result from these recurring formulations. My belief is that, if these shortcomings are avoided, there is nothing to prevent practice-led from further developing as a research inquiry and thus achieving rewarding and successful research outcomes. Originally composed for the purposes of postgraduate supervision, these six rules are presented here in the context of a wider analysis of the emergence of practice-led research and its current conditions of possibility as a research method.

Looking Yonder : Longitudinal Research and Evaluation of the Yonder Participative Arts-based Learning Model Report 2010-2012

Since 2007, KITE Arts Education Program @ QPAC has been engaged in a series of arts and drama-based experiences for students in selected primary schools on the edges of Brisbane and in regional Queensland. The in-school workshop experiences of the program have culminated in a performance by the children for their school community, parents and carers at the Queensland Performing Arts Centre or a regional cultural venue. In conducting an analysis of the Yonder project, the researcher aimed to provide evidence of outcomes brought about through participation by schools, school staff, students and their communities in the Yonder project. To develop longitudinal data project initiators, participants were interviewed at six-monthly intervals to establish patterns of engagement and participation. The report analyses arts-based workshops conducted by the teacher artist in edge-city Brisbane and a regional centre; interviews with teachers and school administrators from the participating schools; interviews with teacher artist and professional artists; interviews with community partners; teacher professional development workshops; community-based workshops; performance outcomes that were the culminating events of the workshop program; student work samples and student reflections on the program. This document covers data and project outputs from February 2010 to July 2012. There have been five iterations of the Yonder project since its commencement in mid-2009 — three in regional Queensland (February–April 2010; February–May 2011; February–May 2012) and two in edge-city1 Brisbane (July–September 2010; August–October 2011). This report is a result of a research partnership between Queensland Performing Arts Centre and Queensland University of Technology (QUT) Creative Industries Faculty(Drama).

Educational and occupational outcomes amongst African men from refugee backgrounds living in urban and regional Southeast Queensland

Over the last ten years, approximately one third of refugee and humanitarian entrants to Australia have been adult men. To date, little research has been done on their health and settlement issues. Many of these men have come from the African continent. This paper reports on the educational and employment outcomes of a group of 173 recently arrived adult African men from refugee backgrounds who have settled in Southeast Queensland. Given the current government policy focus on regional resettlement, the paper compares key outcomes between the adult African men who settled in metropolitan Brisbane with those living in the Toowoomba-Gatton region. The study uses a peer interviewer model and a mixed method approach. Overall, we have found that African men who have settled in regional areas face significantly greater educational and occupational challenges than those who settled in the urban area. They report more negative experiences at educational institutions, are more likely to take jobs that are below their level of skills and qualifications, are more dissatisfied with their jobs, and report greater discrimination and difficulties while trying to secure adequate employment in Australia. A number of policy implications are discussed.

Researching quality and equity in assessment for improved learner outcomes

Quality and equity issues as they relate to assessment practices and policy are becoming increasingly important as Australia introduces a national curriculum and achievement standards. In a context of high-stakes accountability, concerns regarding equity and quality have important implications for teachers‘ practice for the improvement of learner outcomes. This article is based on three research projects that were conducted over the past four years and were funded by the Australian Federal Government. The research focus, emergent questions, the educational contexts, and the rationale for the studies are discussed prior to the presentation of the analysis of the research findings and the implications for teachers‘ practice and policy reform.

Navigating the muddy waters of the research into single sex classrooms in co-educational middle years settings

Establishing single sex classes within co-educational sites is an option that Australian schools are again exploring. To date Australia has experienced three ‘waves’ of interest in establishing single sex classes, the first focused on equitable education opportunities for girls (Alloway & Gilbert, 1997), the second centered on boys’ literacy and engagement (Gilbert & Gilbert, 1998) and this current wave focuses on perceived difference between the sexes in co-educational classrooms (Protheroe, 2009; Gurian, Stevens & Daniels, 2009). With the intersection of middle schooling movement, focusing on learner centered classrooms (Pendergast & Bahr, 2010) and current educational agendas aimed at improving student performance and measurable learning outcomes (Ministerial Council on Education, Employment, Training and Youth Affairs, 2008), it is understandable that schools are exploring such student grouping options. However, after thirty years of international research into the efficacy of single sex classes in co-educational settings, the results still remain unclear. This paper seeks to navigate the ‘muddy waters’ of this body of research and suggests a framework to help guide school communities through the decision-making process associated with considering single sex classes.

A qualitative study of stakeholder views of the conditions for and outcomes of successful clinical networks

The article informs on a research that analyzes the views of the stakeholders on the conditions required for the effective working on the clinical networks and the outcomes that marks the success of the networks. It is mentioned that clinical networks work to improve the health care access and outcome by undertaking innovations and projects based on local requirements. The factors for the success of clinical networks include building relationships, effective leadership and strategic workplans.

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.

Dying in hospital: medical failure or natural outcomes?

The purpose of this study was to describe patterns of medical and nursing practice in the care of patients dying of oncological and hematological malignancies in the acute care setting in Australia. A tool validated in a similar American study was used to study the medical records of 100 consecutive patients who died of oncological or hematological malignancies before August 1999 at The Canberra Hospital in the Australian Capital Territory. The three major indicators of patterns of end-of-life care were documentation of Do Not Resuscitate (DNR) orders, evidence that the patient was considered dying, and the presence of a palliative care intention. Findings were that 88 patients were documented DNR, 63 patients' records suggested that the patient was dying, and 74 patients had evidence of a palliative care plan. Forty-six patients were documented DNR 2 days or less prior to death and, of these, 12 were documented the day of death. Similar patterns emerged for days between considered dying and death, and between palliative care goals and death. Sixty patients had active treatment in progress at the time of death. The late implementation of end-of-life management plans and the lack of consistency within these plans suggested that patients were subjected to medical interventions and investigations up to the time of death. Implications for palliative care teams include the need to educate health care staff and to plan and implement policy regarding the management of dying patients in the acute care setting. Although the health care system in Australia has cultural differences when compared to the American context, this research suggests that the treatment imperative to prolong life is similar to that found in American-based studies.

A comparison of safety climate and safety outcomes between construction and resource functions in a large case study organisation

The research described in this paper forms part of an in-depth investigation of safety culture in one of Australia’s largest construction companies. The research builds on a previous qualitative study with organisational safety leaders and further investigates how safety culture is perceived and experienced by organisational members, as well as how this relates to their safety behaviour and related outcomes at work. Participants were 2273 employees of the case study organisation, with 689 from the Construction function and 1584 from the Resources function. The results of several analyses revealed some interesting organisational variance on key measures. Specifically, the Construction function scored significantly higher on all key measures: safety climate, safety motivation, safety compliance, and safety participation. The results are discussed in terms of relevance in an applied research context.