End-of-life care pathways for improving outcomes in caring for the dying (Protocol)

We aim to assess the effects of end-of-life care pathways, compared with usual care or with care guided by another end-of-life care pathway across all healthcare settings (hospitals, residential aged care facilities, community). In particular, we aim to assess the effects on symptom severity and quality of life of people who are dying and/or those related to the care such as families, caregivers and health professionals.

Recovery and exercise interventions following breast cancer [Abstract]

Over 13,000 women are diagnosed with breast cancer each year in Australia and approximately 90% of these women will survive longer than 5-years. However, survival following treatment for breast cancer is often associated with adverse physical and psychosocial side effects, which persist beyond treatment cessation. As incidence and survival rates associated with breast cancer continue to rise, there is an imperative need to understand the extent of treatment-related concerns and ways in which these concerns can be minimized and/or overcome. A growing body of scientific evidence demonstrates that extensive quality of life benefits can be attained through exercise during and following breast cancer treatment. Such benefits observed include improvements in psychosocial and physical outcomes, as well as better compliance with treatment regimens and reduced impact of disease symptoms and treatment-related side effects. There is also evidence to suggest that post-diagnosis physical activity can improve survival. However, the majority of women newly diagnosed with breast cancer in Australia are not sufficiently active and the majority experience further declines in their physical activity levels during treatment. Throughout the course of this presentation, which draws on data from cohort studies and randomized trials of exercise interventions conducted in Queensland, the potential benefits of exercising during and following breast cancer treatment, the exercise prescription recommended for breast cancer survivors, the limits of our evidence-based knowledge and the issues faced by clinicians and patients with respect to exercise following a cancer diagnosis will be discussed. The question is no longer whether people with breast cancer should be active during and following their treatment, but is how do health care professionals best assist people to become and stay active in an endeavor to live healthy lives beyond their cancer experience.

Choreographing research : supervising the dancing thesis

The dancing doctorate is an interrogative endeavour which can but nurture the art form and forge a beneficial dynamism between those who seek and those who assess the emerging knowledges of dance’. (Vincs, 2009) From 2006-2008 three dance academics from Perth, Brisbane and Melbourne undertook a research project entitled Dancing between Diversity and Consistency: Refining Assessment in Postgraduate Degrees in Dance, funded by the ALTC Priority Projects Program. Although assessment rather than supervision was the primary focus of this research, interviews with 40 examiner/supervisors, 7 research deans and 32 candidates across Australia and across the creative arts, primarily in dance, provide an insight into what might be considered best practice in preparing students for higher research degrees, and the challenges that embodied and experiential knowledges present for supervision. The study also gained the industry perspectives of dance professionals in a series of national forums in 5 cities, based around the value of higher degrees in dance. The qualitative data gathered from these two primary sources was coded and analysed using the NVivo system. Further perspectives were drawn from international consultant and dance researcher Susan Melrose, as well as recent publications in the field. Dance is a young addition to academia and consequently there tends to be a close liaison between the academy and the industry, with a relational fluidity that is both beneficial and problematic. This partially explains why dance research higher degrees are predominantly practice-led (or multi-modal, referring to those theses where practice comprises the substantial examinable component). As a physical, embodied art form, dance engages with the contested territory of legitimising alternative forms of knowledge that do not sit comfortably with accepted norms of research. In supporting research students engaged with dance practice, supervisors traverse the tricky terrain of balancing university academic requirements with studies that are emergent, not only in the practice and attendant theory but in their methodologies and open-ended outcomes; and in an art form in which originality and new knowledge also arises from collaborative creative processes. Formal supervisor accreditation through training is now mandatory in most Australian universities, but it tends to be generic and not address supervisory specificity. This paper offers the kind of alternative proposed by Edwards (2002) that improving postgraduate supervision will be effective if supervisors are empowered to generate their own standards and share best practice; in this case, in ways appropriate to the needs of their discipline and alternative modes of thesis presentation. In order to frame the qualities and processes conducive to this goal, this paper will draw on both the experiences of interviewees and on philosophical premises which underpin the research findings of our study. These include the ongoing challenge of dissolving the binary oppositions of theory and practice, especially in creative arts practice where theory resides in and emerges from the doing as much as in articulating reflection about the doing through what Melrose (2003) terms ‘mixed mode disciplinary practices’. In guiding practitioners through research higher degrees, how do supervisors deal with not only different forms of knowledge but indeed differing modes of knowledge? How can they navigate tensions that occur between the ‘incompatible competencies’ (Candlin, 2000) of the ‘spectating’ academic experts with their ‘irrepressible drive ... to inscribe, interpret, and hence to practise temporal closure’, and practitioner experts who create emergent works of ‘residual unfinishedness’ (Melrose 2006) which are not only embodied but ephemeral, as in the case of live performance?

Dancing doctorates down-under? Defining and assessing ‘doctorateness’ when embodiment enters the thesis

Assessment frames the focus of this paper, which emerges from our collaborative research, Dancing Between Diversity and Consistency: Refining Assessment in Postgraduate Degrees in Dance, funded by the Australian Learning and Teaching Council (ALTC). We examine the attributes of danced ‘doctorateness’, giving special attention to those factors in the Australian environment, which may endow resilience to concepts of excellence, independent thinking and originality when kinaesthetic knowledge becomes pivotal to research. Have the small pool of examiners and relationships between academia and the professional artistic environment shaped these doctorates in a particular way? Can these perspectives illuminate and forge parameters by which to legitimate danced insight? These and related issues are interrogated giving voice to supervisors, research deans, candidates and industry professionals across Australia who participated in this research project.

Dance dialogues : conversations across cultures, artforms and practices

These Proceedings, arising from the 2008 World Dance Alliance Global Summit, reflect both its spirit and diversity, re-appraising what dance is and might be in the 21st century. Through 53 papers from 14 countries in the Americas, Europe and the Asia-Pacific region, the authors — ranging from seasoned scholars to emerging artists publishing for the first time — span the perspectives of academics, educators, performance and community artists, health professionals and cognitive scientists; predominantly from dance but also from film, visual arts, science, performance and philosophy. The papers are grouped under the five Summit themes: Re-thinking the way we make Dance; Re-thinking the way we teach Dance; Mind/body connections; Transcultural conversations and Sustainability

A thematic approach to integrating maths and science for pre-service primary teachers via sustainability

Efforts to improve mathematics and science content knowledge have in many institutions required redefining teacher education through new teaching and learning. See, for example, Peard & Pumadevi (2007) for an account of one such attempt involving the development of a Foundations Unit, Scientific and Quantitative Literacy. This unit is core for all first year pre-service primary teacher education students at Queensland University of Technology (QUT) and two Education Institutes in Malaysia, Institute Perguruan Raja Melewar (IPRM), and Institute Perguruan Teknik (IPT) Kuala Lumpur. Since then, QUT has modified the unit to adopt a thematic approach to the same content. An aim of the unit rewrite was the development of a positive attitude and disposition to the teaching and learning of mathematics and science, with a curiosity and willingness to speculate about and explore the world. Numeracy was specifically identified within the mathematics encountered and appropriately embedded in the science learning area. The importance of the ability to engage in communication of and about mathematics and science was considered crucial to the development of pre-service primary teachers. Cognisance was given to the appropriate selection and use of technology to enhance learning - digital technologies were embedded in the teaching, learning and assessment of the unit to avoid being considered as an optional extra. This was achieved around the theme of “the sustainable school”. This „sustainability‟ theme was selected due to its prominence in Australia‟s futures-oriented National Curriculum which will be implemented in 2011. This paper outlines the approach taken to the implementation of the unit and discusses early indicators of its effectiveness.

A thematic approach to integrating maths and science for pre-service primary teachers via sustainability

Efforts to improve mathematics and science content knowledge have in many institutions required redefining teacher education through new teaching and learning. See, for example, Peard & Pumadevi (2007) for an account of one such attempt involving the development of a Foundations Unit, Scientific and Quantitative Literacy. This unit is core for all first year pre-service primary teacher education students at Queensland University of Technology (QUT) and two Education Institutes in Malaysia, Institute Perguruan Raja Melewar (IPRM), and Institute Perguruan Teknik (IPT) Kuala Lumpur. Since then, QUT has modified the unit to adopt a thematic approach to the same content. An aim of the unit rewrite was the development of a positive attitude and disposition to the teaching and learning of mathematics and science, with a curiosity and willingness to speculate about and explore the world. Numeracy was specifically identified within the mathematics encountered and appropriately embedded in the science learning area. The importance of the ability to engage in communication of and about mathematics and science was considered crucial to the development of pre-service primary teachers. Cognisance was given to the appropriate selection and use of technology to enhance learning - digital technologies were embedded in the teaching, learning and assessment of the unit to avoid being considered as an optional extra. This was achieved around the theme of “the sustainable school”. This ‘sustainability’ theme was selected due to its prominence in Australia’s futures-oriented National Curriculum which will be implemented in 2011. This paper outlines the approach taken to the implementation of the unit and discusses early indicators of its effectiveness.

The right person, in the right job, with the right skills, at the right time. A workforce-planning model that goes beyond metrics

Purpose – The paper aims to describe a workforce-planning model developed in-house in an Australian university library that is based on rigorous environmental scanning of an institution, the profession and the sector. Design/methodology/approach – The paper uses a case study that describes the stages of the planning process undertaken to develop the Library’s Workforce Plan and the documentation produced. Findings – While it has been found that the process has had successful and productive outcomes, workforce planning is an ongoing process. To remain effective, the workforce plan needs to be reviewed annually in the context of the library’s overall planning program. This is imperative if the plan is to remain current and to be regarded as a living document that will continue to guide library practice. Research limitations/implications – Although a single case study, the work has been contextualized within the wider research into workforce planning. Practical implications – The paper provides a model that can easily be deployed within a library without external or specialist consultant skills, and due to its scalability can be applied at department or wider level. Originality/value – The paper identifies the trends impacting on, and the emerging opportunities for, university libraries and provides a model for workforce planning that recognizes the context and culture of the organization as key drivers in determining workforce planning. Keywords - Australia, University libraries, Academic libraries, Change management, Manpower planning Paper type - Case study

neXus2. An investigation into the library and information services workforce in Australia: The institutional perspective. Final report prepared for the Australian Library and Information Association and National and State Libraries Australia

The neXus2 research project has sought to investigate the library and information services (LIS) workforce in Australia, from the institutional or employer perspective. The study builds on the neXus1 study, which collected data from individuals in the LIS workforce in order to present a snapshot of the profession in 2006, highlighting the demographics, educational background and career details of library and information professionals in Australia. To counterbalance this individual perspective, library institutions were invited to participate in a survey to contribute further data as employers. This final report on the neXus2 project compares the findings from the different library sectors, ie academic libraries, TAFE libraries, the National and State libraries, public libraries, special libraries and school libraries.

Teaching and learning science and mathematics through technology practice

In this chapter we review studies of the engagement of students in design projects that emphasise integration of technology practice and the enabling sciences, which include physics and mathematics. We give special attention to affective and conceptual outcomes from innovative interventions of design projects. This is important work because of growing international concern that demand for professionals with technological expertise is increasing rapidly, while the supply of students willing to undertake the rigors of study in the enabling sciences is proportionally reducing (e.g., Barringtion, 2006; Hannover & Kessels, 2004; Yurtseven, 2002). The net effect is that the shortage in qualified workers is having a detrimental effect upon economic and social potential in Westernised countries (e.g., Department of Education, Science and Training [DEST], 2003; National Numeracy Review Panel and National Numeracy Review Secretarial, 2007; Yurtseven, 2002). Interestingly, this trend is reversed in developing economies including China and India (Anderson & Gilbride, 2003).

Clinical supervision in four mental health professions : a review of the evidence

Examines a range of theoretical issues and the empirical evidence relating to clinical supervision in 4 mental health professions: clinical psychology, occupational therapy, social work, and speech pathology. There is widespread acceptance of the value of supervision among practitioners and a large quantity of literature on the topic, but there is very little empirical evidence in this area. To date, there is insufficient evidence to demonstrate which styles of supervision are most beneficial for particular types of staff, in terms of their level of experience or learning style. The data suggest that directive forms of supervision, rather than unstructured approaches, are preferred by relatively inexperienced practitioners, and that experienced clinicians also value direct supervision methods when learning new skills or dealing with complex or crisis situations. The available evidence suggests that supervisors typically receive little training in supervision methods. However, there is little information to guide us as to the most effective ways of training supervisors. While acknowledging the urgent need for research, this paper concludes that supervision is likely to form a valuable component of professional development for mental health professionals.

Issues in multidisciplinary training of cognitive-behavioural interventions

Argues that if brief workshop training is used as the primary method of disseminating behavior therapy skills across professions, it will provide an inadequate preparation, especially for higher levels of behavioral practice. In some circumstances, brief training may lead to an overestimation of behavioral skills by the trainees. These issues are discussed in the context of current moves toward providing health professionals with multiple skills. Examples are provided of situations in which generic health professionals received brief workshop training in behavior therapy and attempted to make use of that training in their jobs. There is no substitute for ongoing training and consultation by senior clinical psychologists who are expert in behavior therapy.

How does ambulance service utilisation impact demand for Emergency Departments in Queensland, Australia?

Background: There are indications that pre-hospital emergency care and management of patients can help reduce the demand for hospital emergency departments (EDs). Ambulance services play a significant role at this stage of care. In 2003, the Queensland Government introduced a Community Ambulance Cover (CAC) levy in return for a free ambulance service at the point of access to all Queenslanders. This may have led to the impression in consumers of an entitlement to free ambulance services under any circumstances regardless of the urgency of the matter which may have in turn contributed to the crowding of EDs in Queensland. Objectives: This paper aims to answer the following questions: - How many patients arrive at hospital EDs by ambulance in Queensland, compared to other modes of arrival? - How has this changed over time, particularly after the CAC introduction in 2003? What percentage of ambulance arrivals are urgent ED patients? - Has the perceived free ambulance services created extra demand for EDs in Queensland, compared with other Australian jurisdictions that charge patients for ambulance services? Methods: We will secondary analyse the data from sources such as Queensland Ambulance Services, Department of Health and Australian Bureau of Statistics to answer the research questions. Findings and Conclusions Queensland has the highest utilization rate of ambulance services (about 18% in 2007-08) and the highest annual growth rate in demand for these services (7.7% on average since 2000-01), well above the population growth. On the other hand, the proportion of ED patients arriving by ambulance in Queensland has increased by about 4% annually. However, when compared with other states and territories with charge at the point of access, it seems that the growth in demand for EDs cannot be explained solely or mainly by CAC or ambulance utilisation in Queensland.

Rare chromosome disorders and their developmental consequences

Professionals working in disability services often encounter clients who have chromosome disorders such as Williams, Angelman or Down syndromes. As chromosome testing becomes increasingly sophisticated, however, more people are being diagnosed with very rare chromosome disorders that are identified not by a syndrome name, but rather by a description of the number, size and shape of their chromosomes (called the karyotype) or by a report of chromosome losses and gains detected through an advanced process known as microarray-based comparative genomic hybridisation (array CGH). For practitioners who work with individuals with rare chromosome disorders and their families, a basic level of knowledge about the evolving field of genetics, as well as specific knowledge about chromosome abnormalities, is essential since they must be able to demonstrate their knowledge and skills to clients (Simic & Turk, 2004). In addition, knowledge about the developmental consequences of various rare chromosome disorders is important for guiding prognoses, expectations, decisions and interventions. The current article provides information that aims to help practitioners work more effectively with this population. It begins by presenting essential information about chromosomes and their numerical and structural abnormalities and then considers the developmental consequences of rare chromosome disorders through a critical review of relevant literature.

Economics and preventing healthcare acquired infection

The evolution of organisms that cause healthcare acquired infections (HAI) puts extra stress on hospitals already struggling with rising costs and demands for greater productivity and cost containment. Infection control can save scarce resources, lives, and possibly a facility’s reputation, but statistics and epidemiology are not always sufficient to make the case for the added expense. Economics and Preventing Healthcare Acquired Infection presents a rigorous analytic framework for dealing with this increasingly serious problem. ----- Engagingly written for the economics non-specialist, and brimming with tables, charts, and case examples, the book lays out the concepts of economic analysis in clear, real-world terms so that infection control professionals or infection preventionists will gain competence in developing analyses of their own, and be confident in the arguments they present to decision-makers. The authors: ----- Ground the reader in the basic principles and language of economics. ----- Explain the role of health economists in general and in terms of infection prevention and control. ----- Introduce the concept of economic appraisal, showing how to frame the problem, evaluate and use data, and account for uncertainty. ----- Review methods of estimating and interpreting the costs and health benefits of HAI control programs and prevention methods. ----- Walk the reader through a published economic appraisal of an infection reduction program. ----- Identify current and emerging applications of economics in infection control. ---- Economics and Preventing Healthcare Acquired Infection is a unique resource for practitioners and researchers in infection prevention, control and healthcare economics. It offers valuable alternate perspective for professionals in health services research, healthcare epidemiology, healthcare management, and hospital administration. ----- Written for: Professionals and researchers in infection control, health services research, hospital epidemiology, healthcare economics, healthcare management, hospital administration; Association of Professionals in Infection Control (APIC), Society for Healthcare Epidemiologists of America (SHEA)