Conceptions of school based youth health nursing : a phenomenographic study

The School Based Youth Health Nurse Program was established in 1999 by the Queensland Government to fund school nurse positions in Queensland state high schools. Schools were required to apply for a School Based Youth Health Nurse during a five-phase recruitment process, managed by the health districts, and rolled out over four years. The only mandatory selection criterion for the position of School Based Youth Health Nurse was registration as a General Nurse and most School Based Youth Health Nurses are allocated to two state high schools. Currently, there are approximately 115 Full Time Equivalent School Based Youth Health Nurse positions across all Queensland state high schools. The literature review revealed an abundance of information about school nursing. Most of the literature came from the United Kingdom and the United States, who have a different model of school nursing to school based youth health nursing. However, there is literature to suggest school nursing is gradually moving from a disease-focused approach to a social view of health. The noticeable number of articles about, for example, drug and alcohol, mental health, and contemporary sexual health issues, is evidence of this change. Additionally, there is a significant the volume of literature about partnerships and collaboration, much of which is about health education, team teaching and how school nurses and schools do health business together. The surfacing of this literature is a good indication that school nursing is aligning with the broader national health priority areas. More particularly, the literature exposed a small but relevant and current body of research, predominantly from Queensland, about school based youth health nursing. However, there remain significant gaps in the knowledge about school based youth health nursing. In particular, there is a deficit about how School Based Youth Heath Nurses understand the experience of school based youth health nursing. This research aimed to reveal the meaning of the experience of school based youth health nursing. The research question was How do School Based Youth Health Nurses’ understand the experience of school based youth health nursing? This enquiry was instigated because the researcher, who had a positive experience of school based youth health nursing, considered it important to validate other School Based Youth Health Nurses’ experiences. Consequently, a comprehensive use of qualitative research was considered the most appropriate manner to explore this research question. Within this qualitative paradigm, the research framework consists of the epistemology of social constructionism, the theoretical perspective of interpretivism and the approach of phenomenography. After ethical approval was gained, purposeful and snowball sampling was used to recruit a sample of 16 participants. In-depth interviews, which were voluntary, confidential and anonymous, were mostly conducted in public venues and lasted from 40-75 minutes. The researcher also kept a researchers journal as another form of data collection. Data analysis was guided by Dahlgren and Fallsbergs’ (1991, p. 152) seven phases of data analysis which includes familiarization, condensation, comparison, grouping, articulating, labelling and contrasting. The most important finding in this research is the outcome space, which represents the entirety of the experience of school based youth health nursing. The outcome space consists of two components: inside the school environment and outside the school environment. Metaphorically and considered as whole-in-themselves, these two components are not discreet but intertwined with each other. The outcome space consists of eight categories. Each category of description is comprised of several sub-categories of description but as a whole, is a conception of school based youth health nursing. The eight conceptions of school based youth health nursing are: 1. The conception of school based youth health nursing as out there all by yourself. 2. The conception of school based youth health nursing as no real backup. 3. The conception of school based youth health nursing as confronted by many barriers. 4. The conception of school based youth health nursing as hectic and full-on. 5. The conception of school based youth health nursing as working together. 6. The conception of school based youth health nursing as belonging to school. 7. The conception of school based youth health nursing as treated the same as others. 8. The conception of school based youth health nursing as the reason it’s all worthwhile. These eight conceptions of school based youth health nursing are logically related and form a staged hierarchical relationship because they are not equally dependent on each other. The conceptions of school based youth health nursing are grouped according to negative, negative and positive and positive conceptions of school based youth health nursing. The conceptions of school based youth health nursing build on each other, from the bottom upwards, to reach the authorized, or the most desired, conception of school based youth health nursing. This research adds to the knowledge about school nursing in general but especially about school based youth health nursing specifically. Furthermore, this research has operational and strategic implications, highlighted in the negative conceptions of school based youth health nursing, for the School Based Youth Health Nurse Program. The researcher suggests the School Based Youth Health Nurse Program, as a priority, address the operational issues The researcher recommends a range of actions to tackle issues and problems associated with accommodation and information, consultations and referral pathways, confidentiality, health promotion and education, professional development, line management and School Based Youth Health Nurse Program support and school management and community. Strategically, the researcher proposes a variety of actions to address strategic issues, such as the School Based Youth Health Nurse Program vision, model and policy and practice framework, recruitment and retention rates and evaluation. Additionally, the researcher believes the findings of this research have the capacity to spawn a myriad of future research projects. The researcher has identified the most important areas for future research as confidentiality, information, qualifications and health outcomes.

Destination branding case study : tracking brand equity for an emerging destination between 2003 and 2007

Place branding has become a major focus of operations for destination marketing organizations (DMOs) striving for differentiation in cluttered markets. The topic of destination branding has only received attention in the tourism literature since the late 1990s, and there has been relatively little research reported in relations to analyzing destination brand effectiveness over time. This article reports an attempt to oprationalize the concept of consumer-based brand equity (CBBE) for an emerging destination over two points in time. The purpose of the project was to track the effectiveness of the brand in 2007 against benchmarks that were established in a 2003 student at the commencement of a new destination brand campaign. The key finding was there was no change in perceived performance for the destination across the brand's performance indicators and CBBE dimensions. Because of the common challenges faced by DMOs worldwide, it is suggested the CBBE hierarchy provides destination marketers with a practical tool for evaluation brand performance over time.

Empirical evaluation of a service analysis and design methodology

Service-orientation has gained widespread acceptance and is increasingly being employed as a paradigm for structuring both business and IT architectures. An earlier study of extant service analysis and design methodologies discovered a need for holistic approaches that equally account for both business and software services, which motivated the design of a new, consolidated service analysis and design methodology. A challenge in design-oriented research is to evaluate the utility of the newly created artefacts (here: the methodology), as they are often intended to become part of complex socio-technical systems. Therefore, after presenting a brief overview of the consolidated methodology, the paper discusses possible approaches for the “evaluate” phase of this design-science research process and presents the results of an empirical evaluation conducted in an Action Research study at one of Australia’s largest financial services providers.

ERP systems in the higher education sector : a descriptive study

In response to a range of contextual drivers, the worldwide adoption of ERP Systems in Higher Education Institutions (HEIs) has increased substantially over the past decade. Though this demand continues to grow, with HEIs now a main target market for ERP vendors, little has been published on the topic. This paper reports a sub-study of a larger research effort that aims to contribute to understanding the phenomenon of ERP adoption and evaluation in HEIs in the Australasian region. It presents a descriptive case study conducted at Queensland University of Technology (QUT) in Australia, with emphasis on challenges with ERP adoption. The case study provides rich contextual details about ERP system selection, customisation, integration and evaluation, and insights into the role of consultants in the HE sector. Through this analysis, the paper (a) provides evidence of the dearth of ERP literature pertaining to the HE sector; (b) yields insights into differentiating factors in the HE sector that warrants specific research attention, and (c) offers evidence of how key ERP decisions such as systems selection, customisation, integration, evaluation, and consultant engagement are influenced by the specificities of the HE sector.

Understanding Shared Services : an exploration of the IS literature

In a competitive environment, companies continuously innovate to offer superior services at lower costs. ‘Shared services’ have been extensively adopted in practice as one means for improving organisational performance. Shared services is considered most appropriate for support functions, and is widely adopted in Human Resource Management, Finance and Accounting; more recently being employed across the Information Systems function. IS applications and infrastructure are an important enabler and driver of shared services in all functional areas. As computer based corporate information systems have become de facto and the internet pervasive and increasingly the backbone of administrative systems, the technical impediments to sharing have come down dramatically. As this trend continues, CIOs and IT professionals will need a deeper understanding of the shared services phenomenon and its implications. The advent of shared services has consequential implications for the IS academic discipline. Yet, archival analysis of IS the academic literature reveals that shared services, though mentioned in more than 100 articles, has received little in depth attention. This paper is the first attempt to investigate and report on the current status of shared services in the IS literature. The paper presents detailed review of literature from main IS journals and conferences, findings evidencing a lack of focus and definitions and objectives lacking conceptual rigour. The paper concludes with a tentative operational definition, a list of perceived main objectives of shared services, and an agenda for related future research.

Assessing reflection skills in law using criterion-referenced assessment

This paper focuses on the assessment of reflective practice, an issue that has not been fully explored within legal education literature. While the issue of how reflective practice should be taught is one that requires careful consideration, it is beyond the scope of this paper to consider both the teaching and the assessment of reflective practice. Part II of this paper conceptualises reflective practice, and Part III explores the benefits of reflective practice in legal education and the use of reflective writing to assess experiential learning in a legal context. Part IV considers the diverse issues that arise in assessing reflective practice and whether there is an objective method for assessing reflection. Part V of the paper examines the assessment of reflective practice in the context of an exemplar undergraduate law subject that uses a reflective report to assess students’ experiential learning during a court visit.14 Finally, Part VI offers a rubric to facilitate criterion-referenced assessment of reflective practice and thereby provides a framework for assessing reflection skills. It is suggested that the rubric is transferable not only to other law subjects but also to subjects in other disciplines.

Does the summative assessment of real world learning using criterion-referenced assessment need to be discipline specific?

This paper synthesises the existing literature on the contemporary conception of ‘real world’ and compares it with similar notions such as ‘authentic’ and ‘work integrated learning’. While the term ‘real world’ may be partly dependent on the discipline, it does not necessarily follow that the criterion-referenced assessment of ‘real world’ assessment must involve criteria and performance descriptors that are discipline specific. Two examples of summative assessment (court report and trial process exercise) from a final year core subject at the Queensland University of Technology, LWB432 Evidence, emphasise real world learning, are authentic, innovative and better prepare students for the transition into the workplace than more generic forms of assessment such as tutorial participation or oral presentations. The court report requires students to attend a criminal trial in a Queensland Court and complete a two page report on what they saw in practice compared with what they learned in the classroom. The trial process exercise is a 50 minute written closed book activity conducted in tutorials, where students plan questions that they would ask their witness in examination-in-chief, plan questions that they would ask their opponent’s witness in cross-examination, plan questions that they would ask in reexamination given what their opponent asked in cross-examination, and prepare written objections to their opponent’s questions. The trial process exercise simulates the real world, whereas the court report involves observing the real world, and both assessment items are important to the role of counsel. The design of the criterion-referenced assessment rubrics for the court report and trial process exercise is justified by the literature. Notably, the criteria and performance descriptors are not necessarily law specific and this paper highlights the parts that may be easily transferred to other disciplines.

Evaluating information systems

The book within which this chapter appears is published as a research reference book (not a coursework textbook) on Management Information Systems (MIS) for seniors or graduate students in Chinese universities. It is hoped that this chapter, along with the others, will be helpful to MIS scholars and PhD/Masters research students in China who seek understanding of several central Information Systems (IS) research topics and related issues. The subject of this chapter - ‘Evaluating Information Systems’ - is broad, and cannot be addressed in its entirety in any depth within a single book chapter. The chapter proceeds from the truism that organizations have limited resources and those resources need to be invested in a way that provides greatest benefit to the organization. IT expenditure represents a substantial portion of any organization’s investment budget and IT related innovations have broad organizational impacts. Evaluation of the impact of this major investment is essential to justify this expenditure both pre- and post-investment. Evaluation is also important to prioritize possible improvements. The chapter (and most of the literature reviewed herein) admittedly assumes a blackbox view of IS/IT1, emphasizing measures of its consequences (e.g. for organizational performance or the economy) or perceptions of its quality from a user perspective. This reflects the MIS emphasis – a ‘management’ emphasis rather than a software engineering emphasis2, where a software engineering emphasis might be on the technical characteristics and technical performance. Though a black-box approach limits diagnostic specificity of findings from a technical perspective, it offers many benefits. In addition to superior management information, these benefits may include economy of measurement and comparability of findings (e.g. see Part 4 on Benchmarking IS). The chapter does not purport to be a comprehensive treatment of the relevant literature. It does, however, reflect many of the more influential works, and a representative range of important writings in the area. The author has been somewhat opportunistic in Part 2, employing a single journal – The Journal of Strategic Information Systems – to derive a classification of literature in the broader domain. Nonetheless, the arguments for this approach are believed to be sound, and the value from this exercise real. The chapter drills down from the general to the specific. It commences with a highlevel overview of the general topic area. This is achieved in 2 parts: - Part 1 addressing existing research in the more comprehensive IS research outlets (e.g. MISQ, JAIS, ISR, JMIS, ICIS), and Part 2 addressing existing research in a key specialist outlet (i.e. Journal of Strategic Information Systems). Subsequently, in Part 3, the chapter narrows to focus on the sub-topic ‘Information Systems Success Measurement’; then drilling deeper to become even more focused in Part 4 on ‘Benchmarking Information Systems’. In other words, the chapter drills down from Parts 1&2 Value of IS, to Part 3 Measuring Information Systems Success, to Part 4 Benchmarking IS. While the commencing Parts (1&2) are by definition broadly relevant to the chapter topic, the subsequent, more focused Parts (3 and 4) admittedly reflect the author’s more specific interests. Thus, the three chapter foci – value of IS, measuring IS success, and benchmarking IS - are not mutually exclusive, but, rather, each subsequent focus is in most respects a sub-set of the former. Parts 1&2, ‘the Value of IS’, take a broad view, with much emphasis on ‘the business Value of IS’, or the relationship between information technology and organizational performance. Part 3, ‘Information System Success Measurement’, focuses more specifically on measures and constructs employed in empirical research into the drivers of IS success (ISS). (DeLone and McLean 1992) inventoried and rationalized disparate prior measures of ISS into 6 constructs – System Quality, Information Quality, Individual Impact, Organizational Impact, Satisfaction and Use (later suggesting a 7th construct – Service Quality (DeLone and McLean 2003)). These 6 constructs have been used extensively, individually or in some combination, as the dependent variable in research seeking to better understand the important antecedents or drivers of IS Success. Part 3 reviews this body of work. Part 4, ‘Benchmarking Information Systems’, drills deeper again, focusing more specifically on a measure of the IS that can be used as a ‘benchmark’3. This section consolidates and extends the work of the author and his colleagues4 to derive a robust, validated IS-Impact measurement model for benchmarking contemporary Information Systems (IS). Though IS-Impact, like ISS, has potential value in empirical, causal research, its design and validation has emphasized its role and value as a comparator; a measure that is simple, robust and generalizable and which yields results that are as far as possible comparable across time, across stakeholders, and across differing systems and systems contexts.

Barriers to the acceptance of road safety programmes among rural road users : developing a brief intervention

Motorised countries have more fatal road crashes in rural areas than in urban areas. In Australia, over two thirds of the population live in urban areas, yet approximately 55 percent of the road fatalities occur in rural areas (ABS, 2006; Tziotis, Mabbot, Edmonston, Sheehan & Dwyer, 2005). Road and environmental factors increase the challenges of rural driving, but do not fully account for the disparity. Rural drivers are less compliant with recommendations regarding the “fatal four” behaviours of speeding, drink driving, seatbelt non-use and fatigue, and the reasons for their lower apparent receptivity for road safety messages are not well understood. Countermeasures targeting driver behaviour that have been effective in reducing road crashes in urban areas have been less successful in rural areas (FORS, 1995). However, potential barriers to receptivity for road safety information among rural road users have not been systematically investigated. This thesis aims to develop a road safety countermeasure that addresses three areas that potentially affect receptivity to rural road safety information. The first is psychological barriers of road users’ attitudes, including risk evaluation, optimism bias, locus of control and readiness to change. A second area is the timing and method of intervention delivery, which includes the production of a brief intervention and the feasibility of delivering it at a “teachable moment”. The third area under investigation is the content of the brief intervention. This study describes the process of developing an intervention that includes content to address road safety attitudes and improve safety behaviours of rural road users regarding the “fatal four”. The research commences with a review of the literature on rural road crashes, brief interventions, intervention design and implementation, and potential psychological barriers to receptivity. This literature provides a rationale for the development of a brief intervention for rural road safety with a focus on driver attitudes and behaviour. The research is then divided into four studies. The primary aim of Study One and Study Two is to investigate the receptivity of rural drivers to road safety interventions, with a view to identifying barriers to the efficacy of these strategies.

Design and evaluation of an image analysis platform for low-power, low-bandwidth camera networks

We describe the design and evaluation of a platform for networks of cameras in low-bandwidth, low-power sensor networks. In our work to date we have investigated two different DSP hardware/software platforms for undertaking the tasks of compression and object detection and tracking. We compare the relative merits of each of the hardware and software platforms in terms of both performance and energy consumption. Finally we discuss what we believe are the ongoing research questions for image processing in WSNs.

Can tissue engineering concepts advance tumor biology research?

Advances in tissue engineering have traditionally led to the design of scaffold- or matrix-based culture systems that better reflect the biological, physical and biochemical environment of the natural extracellular matrix. Although their clinical applications in regenerative medicine tend to receive most of the attention, it is obvious that other areas of biomedical research could be well served by the powerful tools that have already been developed in tissue engineering. In this article, we review the recent literature to demonstrate how tissue engineering platforms can enhance in vitro and in vivo models of tumorigenesis and thus hold great promise to contribute to future cancer research.

Setting hospital infection control policy : a decision-making framework incorporating health economics and healthcare epidemiology

Background: Reducing rates of healthcare acquired infection has been identified by the Australian Commission on Safety and Quality in Health Care as a national priority. One of the goals is the prevention of central venous catheter-related bloodstream infection (CR-BSI). At least 3,500 cases of CR-BSI occur annually in Australian hospitals, resulting in unnecessary deaths and costs to the healthcare system between $25.7 and $95.3 million. Two approaches to preventing these infections have been proposed: use of antimicrobial catheters (A-CVCs); or a catheter care and management ‘bundle’. Given finite healthcare budgets, decisions about the optimal infection control policy require consideration of the effectiveness and value for money of each approach. Objectives: The aim of this research is to use a rational economic framework to inform efficient infection control policy relating to the prevention of CR-BSI in the intensive care unit. It addresses three questions relating to decision-making in this area: 1. Is additional investment in activities aimed at preventing CR-BSI an efficient use of healthcare resources? 2. What is the optimal infection control strategy from amongst the two major approaches that have been proposed to prevent CR-BSI? 3. What uncertainty is there in this decision and can a research agenda to improve decision-making in this area be identified? Methods: A decision analytic model-based economic evaluation was undertaken to identify an efficient approach to preventing CR-BSI in Queensland Health intensive care units. A Markov model was developed in conjunction with a panel of clinical experts which described the epidemiology and prognosis of CR-BSI. The model was parameterised using data systematically identified from the published literature and extracted from routine databases. The quality of data used in the model and its validity to clinical experts and sensitivity to modelling assumptions was assessed. Two separate economic evaluations were conducted. The first evaluation compared all commercially available A-CVCs alongside uncoated catheters to identify which was cost-effective for routine use. The uncertainty in this decision was estimated along with the value of collecting further information to inform the decision. The second evaluation compared the use of A-CVCs to a catheter care bundle. We were unable to estimate the cost of the bundle because it is unclear what the full resource requirements are for its implementation, and what the value of these would be in an Australian context. As such we undertook a threshold analysis to identify the cost and effectiveness thresholds at which a hypothetical bundle would dominate the use of A-CVCs under various clinical scenarios. Results: In the first evaluation of A-CVCs, the findings from the baseline analysis, in which uncertainty is not considered, show that the use of any of the four A-CVCs will result in health gains accompanied by cost-savings. The MR catheters dominate the baseline analysis generating 1.64 QALYs and cost-savings of $130,289 per 1.000 catheters. With uncertainty, and based on current information, the MR catheters remain the optimal decision and return the highest average net monetary benefits ($948 per catheter) relative to all other catheter types. This conclusion was robust to all scenarios tested, however, the probability of error in this conclusion is high, 62% in the baseline scenario. Using a value of $40,000 per QALY, the expected value of perfect information associated with this decision is $7.3 million. An analysis of the expected value of perfect information for individual parameters suggests that it may be worthwhile for future research to focus on providing better estimates of the mortality attributable to CR-BSI and the effectiveness of both SPC and CH/SSD (int/ext) catheters. In the second evaluation of the catheter care bundle relative to A-CVCs, the results which do not consider uncertainty indicate that a bundle must achieve a relative risk of CR-BSI of at least 0.45 to be cost-effective relative to MR catheters. If the bundle can reduce rates of infection from 2.5% to effectively zero, it is cost-effective relative to MR catheters if national implementation costs are less than $2.6 million ($56,610 per ICU). If the bundle can achieve a relative risk of 0.34 (comparable to that reported in the literature) it is cost-effective, relative to MR catheters, if costs over an 18 month period are below $613,795 nationally ($13,343 per ICU). Once uncertainty in the decision is considered, the cost threshold for the bundle increases to $2.2 million. Therefore, if each of the 46 Level III ICUs could implement an 18 month catheter care bundle for less than $47,826 each, this approach would be cost effective relative to A-CVCs. However, the uncertainty is substantial and the probability of error in concluding that the bundle is the cost-effective approach at a cost of $2.2 million is 89%. Conclusions: This work highlights that infection control to prevent CR-BSI is an efficient use of healthcare resources in the Australian context. If there is no further investment in infection control, an opportunity cost is incurred, which is the potential for a more efficient healthcare system. Minocycline/rifampicin catheters are the optimal choice of antimicrobial catheter for routine use in Australian Level III ICUs, however, if a catheter care bundle implemented in Australia was as effective as those used in the large studies in the United States it would be preferred over the catheters if it was able to be implemented for less than $47,826 per Level III ICU. Uncertainty is very high in this decision and arises from multiple sources. There are likely greater costs to this uncertainty for A-CVCs, which may carry hidden costs, than there are for a catheter care bundle, which is more likely to provide indirect benefits to clinical practice and patient safety. Research into the mortality attributable to CR-BSI, the effectiveness of SPC and CH/SSD (int/ext) catheters and the cost and effectiveness of a catheter care bundle in Australia should be prioritised to reduce uncertainty in this decision. This thesis provides the economic evidence to inform one area of infection control, but there are many other infection control decisions for which information about the cost-effectiveness of competing interventions does not exist. This work highlights some of the challenges and benefits to generating and using economic evidence for infection control decision-making and provides support for commissioning more research into the cost-effectiveness of infection control.

An adolescent injury intervention : selecting targeted behaviours with implications for program design and evaluation

Objectives: This paper sought to identify the behaviour change targets for an injury prevention program; Skills for Preventing Injury in Youth, SPIY. The aim was to explore how such behaviours could subsequently be implemented and evaluated in the program. Methods and Design: The quantitative procedure involved a survey with 267 Year 8 and 9 students (mean age 13.23 years) regarding their engagement in risk-taking behaviours that may lead to injury. The qualitative study involved 30 students aged 14 to 17 years reporting their experiences of injury and risk-taking. Results: Injury risk behaviours co-occurred among three-quarters of those who reported engaging in any alcohol use or transport or violence related injury risk behaviour. Students described in detail some of these experiences. Conclusions: The selection process of identifying target behaviours for change for an injury prevention program is described. Adolescents’ description of such risk behaviours can inform the process of operationalising and contextualising program content and deciding on evaluation methodology. The design of an effective injury prevention program involves considerable preparatory work and this paper was able to describe the process of identifying the behavioural targets for change that can be operationalised and evaluated in the injury prevention program, SPIY.