Study Protocol - Alcohol Management Plans (AMPs) in remote indigenous communities in Queensland: their impacts on injury, violence, health and social indicators and their cost-effectiveness

Background In 2002/03 the Queensland Government responded to high rates of alcohol-related harm in discrete Indigenous communities by implementing alcohol management plans (AMPs), designed to include supply and harm reduction and treatment measures. Tighter alcohol supply and carriage restrictions followed in 2008 following indications of reductions in violence and injury. Despite the plans being in place for over a decade, no comprehensive independent review has assessed to what level the designed aims were achieved and what effect the plans have had on Indigenous community residents and service providers. This study will describe the long-term impacts on important health, economic and social outcomes of Queensland’s AMPs. Methods/Design The project has two main studies, 1) outcome evaluation using de-identified epidemiological data on injury, violence and other health and social indicators for across Queensland, including de-identified databases compiled from relevant routinely-available administrative data sets, and 2) a process evaluation to map the nature, timing and content of intervention components targeting alcohol. Process evaluation will also be used to assess the fidelity with which the designed intervention components have been implemented, their uptake and community responses to them and their perceived impacts on alcohol supply and consumption, injury, violence and community health. Interviews and focus groups with Indigenous residents and service providers will be used. The study will be conducted in all 24 of Queensland’s Indigenous communities affected by alcohol management plans. Discussion This evaluation will report on the impacts of the original aims for AMPs, what impact they have had on Indigenous residents and service providers. A central outcome will be the establishment of relevant databases describing the parameters of the changes seen. This will permit comprehensive and rigorous surveillance systems to be put in place and provided to communities empowering them with the best credible evidence to judge future policy and program requirements for themselves. The project will inform impending alcohol policy and program adjustments in Queensland and other Australian jurisdictions. The project has been approved by the James Cook University Human Research Ethics Committee (approval number H4967 & H5241).

Paratransit demand of disabled people

This paper estimates the demand for transportation systems that are used primarily by disabled individuals. These systems are known as paratransit systems and have experienced large increases in number and average size over the past 15 years. We first use a national database and standard time series techniques to model aggregate demand. We then use a unique data set of administrative records from a paratransit system in central Virginia to estimate standard and nonstandard count models of individual demand. We conclude that most of the demand growth is from new passengers, but that predicting the growth of new passengers is very difficult. Our results also highlight the importance of incorporating autocorrelation and possible sample attrition into standard count models.

Survival models of community tenure and length of hospital stay for the seriously mentally ill : a 10-year perspective

Objective: To examine the effects of personal and community characteristics, specifically race and rurality, on lengths of state psychiatric hospital and community stays using maximum likelihood survival analysis with a special emphasis on change over a ten year period of time. Data Sources: We used the administrative data of the Virginia Department of Mental Health, Mental Retardation, and Substance Abuse Services (DMHMRSAS) from 1982-1991 and the Area Resources File (ARF). Given these two sources, we constructed a history file for each individual who entered the state psychiatric system over the ten year period. Histories included demographic, treatment, and community characteristics. Study Design: We used a longitudinal, population-based design with maximum likelihood estimation of survival models. We presented a random effects model with unobserved heterogeneity that was independent of observed covariates. The key dependent variables were lengths of inpatient stay and subsequent length of community stay. Explanatory variables measured personal, diagnostic, and community characteristics, as well as controls for calendar time. Data Collection: This study used secondary, administrative, and health planning data. Principal Findings: African-American clients leave the community more quickly than whites. After controlling for other characteristics, however, race does not affect hospital length of stay. Rurality does not affect length of community stays once other personal and community characteristics are controlled for. However, people from rural areas have longer hospital stays even after controlling for personal and community characteristics. The effects of time are significantly smaller than expected. Diagnostic composition effects and a decrease in the rate of first inpatient admissions explain part of this reduced impact of time. We also find strong evidence for the existence of unobserved heterogeneity in both types of stays and adjust for this in our final models. Conclusions: Our results show that information on client characteristics available from inpatient stay records is useful in predicting not only the length of inpatient stay but also the length of the subsequent community stay. This information can be used to target increased discharge planning for those at risk of more rapid readmission to inpatient care. Correlation across observed and unobserved factors affecting length of stay has significant effects on the measurement of relationships between individual factors and lengths of stay. Thus, it is important to control for both observed and unobserved factors in estimation.

Assessment of revised recruitment standards for asthma in the Australian Defence Force

Objective To assess the impact of relaxed asthma recruitment standards adopted by the Australian Defence Force (ADF) in 2007. Methods A retrospective audit was conducted on clinical and administrative data for recruits, with and without mild asthma, in their first year of service. Results There was no evidence that mild asthmatics experienced worse outcomes than nonasthmatic recruits. Mild asthmatics had fewer illnesses and restricted duty days and were less costly compared to other recruits. There was no difference in the rate of discharge (attrition) between those with and without mild asthma. Conclusions The revised recruitment standards for asthma in the ADF have not resulted in unanticipated medical or administrative costs to the organisation. Health and administrative outcomes differed little between mild asthmatics and non-asthmatic recruits in their first twelve months of service.

Genetic and phenotypic evidence supports evolutionary divergence of the American flamingo (Phoenicopterus ruber) population in the Galapagos islands

The Galapagos archipelago is characterized by a high degree of endemism across many taxa, linked to the archpelago's oceanic origin and distance from other colonizing land masses. A population of ~ 500 American Flamingos (Phoenicopterus ruber) resides in Galapagos, which is thought to share an historical origin with the American Flamingo currently found in the Caribbean region. Genetic and phenotypic parameters in American Flamingos from Galapagos and from the Caribbean were investigated. Microsatellite and microchondrial DNA markers data showed that the American Flamingo population in Galapagos differs genetically from that in the Caribbean. American Flamingos in Galapagos form a clade which differs by a single common nucleotide substitution from American Flamingos in the Caribbean. The genetic differentiation is also evident from nuclear DNA in that microsatellite data reveal a number of private alleles for the American Flamingo in Galapagos. Analysis of skeletal measurements showed that American Flamingos in Galapagos are smaller than those in the Caribbean primarily due to shorter tarsus length, and differences in body shape sexual dimorphism. American Flamingo eggs from Galapagos have smaller linear dimensions and volumes than those from the Caribbean. The findings are consistent with reproductive isolation of American Flamingo population in Galapagos.

Development and pilot study of the Primary Care Practice Improvement Tool (PC-PIT) : an innovative approach

Objective To assess the usability and validity of the Primary Care Practice Improvement Tool (PC-PIT), a practice performance improvement tool based on 13 key elements identified by a systematic review. It was co-created with a range of partners and designed specifically for primary health care. Design This pilot study examined the PC-PIT using a formative assessment framework and mixed-methods research design. Setting and participants Six high-functioning general practices in Queensland, Australia, between February and July 2013. A total of 28 staff participated — 10 general practitioners, six practice or community nurses, 12 administrators (four practice managers; one business manager and eight reception or general administrative staff). Main outcome measures Readability, content validity and staff perceptions of the PC-PIT. Results The PC-PIT offers an appropriate and acceptable approach to internal quality improvement in general practice. Quantitative assessment scores and qualitative data from all staff identified two areas in which the PC-PIT required modification: a reduction in the indicative reading age, and simplification of governance-related terms and concepts. Conclusion The PC-PIT provides an innovative approach to address the complexity of organisational improvement in general practice and primary health care. This initial validation will be used to develop a suite of supporting, high-quality and free-to-access resources to enhance the use of the PC-PIT in general practice. Based on these findings, a national trial is now underway.

Enterprise system lifecycle-wide innovation - research in progress

Enterprise Systems purport to bring innovation to organizations. Yet, no past studies, neither from innovation nor from ES disciplines have merged their knowledge to understand how ES could facilitate lifecycle-wide innovation. Therefore, this study forms conceptual bridge between the two disciplines. In this research, we seek to understand how ES could facilitate innovation across its lifecycle phases. We associate classifications of innovation such as radical vs. incremental, administrative vs. technical innovation with the three phases of ES lifecycle. We introduce Continuous Restrained Innovation (CRI) as a new type of innovation specific to ES, considering restraints of technology, business processes and organization. Our empirical data collection at the implementation phase, using data from both the client and implementation partner, shows preliminary evidence of CRI. In addition, we state that both parties consider the implementation of ES as a radical innovation yet, are less interest in seeking further innovations through the system.

Industry in Jarrow

This study was done during 1958-59 as part of a geography major at London Institute of Education, Eastbourne Teachers' Training College, Sussex 1957-59. (Age 19) I visited all factories, industries and wharfs on my bicycle and interviewed managers, owners and supervisors.

E-mail in the workplace : the role of stress appraisals and normative response pressure in the relationship between email stressors and employee strain

In many organizations, e-mail is an effective and dominant workplace application tool; however, research identifying its role as a potential workplace stressor remains limited. Utilizing the Transactional Model of Stress (Lazarus & Folkman, 1984), 215 full-time administrative and academic staff at a university were surveyed about workplace e-mail. The aim was to study the effects of potential e-mail stressors on emotional exhaustion as mediated and moderated by person and situation variables. Results indicated that 2 distinct e-mail stressors—high quantity and poor quality (in terms of high emotionality and ambiguity) of workplace e-mail—were associated both with stress appraisals (e-mail overload and e-mail uncertainty) and with emotional exhaustion. Furthermore, the effects of the 2 e-mail stressors on emotional exhaustion were mediated by appraised e-mail overload. Perceived normative response pressure—a relevant aspect of the specific work environment—added to the explanation of emotional exhaustion and accentuated the positive effect of e-mail ambiguity on emotional exhaustion, although effects involving normative response pressure were not explained by the stress appraisals.

Re-framing planning decision-making : increasing flood resilience in Jakarta

Purpose – Rapid urbanisation, fragmented governance and recurrent flooding complicates resolution of DKI Jakarta’s chronic housing shortage. Failure to effectively implement planning decisionmaking processes poses potential human rights violations. Contemporary planning policy requires the relocation of households living in floodplains within fifteen metres of DKI Jakarta’s main watercourses; further constraining land availability and potentially requiring increased densification. The purpose of this paper is to re-frame planning decision-making to address risks of flooding and to increase community resilience. Design/methodology/approach – This paper presents a preliminary scoping study for a technologically enhanced participatory planning method, incorporating synthesis of existing information on urbanisation, governance, and flood risk management in Jakarta. Findings – Responsibility for flood risk management in DKI Jakarta is fragmented both within and across administrative boundaries. Decision-making is further complicated by: limited availability of land use data; uncertainty as to the delineated extent of watercourses, floodplains, and flood modelling; unclear risk and liability for infrastructure investments; and technical literacy of both public and government participants. Practical implications – This research provides information to facilitate consultation with government entities tasked with re-framing planning processes to increase public participation. Social implications – Reduction in risk exposure amongst DKI Jakarta’s most vulnerable populations addresses issues of social justice.

More than just friends? Facebook, disclosive ethics and the morality of technology

Social networking sites have become increasingly popular destinations for people wishing to chat, play games, make new friends or simply stay in touch. Furthermore, many organizations have been quick to grasp the potential they offer for marketing, recruitment and economic activities. Nevertheless, counterclaims depict such spaces as arenas where deception, social grooming and the posting of defamatory content flourish. Much research in this area has focused on the ends to which people deploy the technology, and the consequences arising, with a view to making policy recommendations and ethical interventions. In this paper, we argue that tracing where morality lies is more complex than these efforts suggest. Using the case of a popular social networking site, and concepts about the morality of technology, we disclose the ethics of Facebook as diffuse and multiple. In our conclusions we provide some reflections on the possibilities for action in light of this disclosure.

A business perspective of legacy systems

Abstract Legacy information systems evolved incrementally in response to changes in business strategy and information technology. Organizations are now being forced to change much more radically and quickly than previously and this change places new demands on information systems. Legacy information systems are usually considered from a technical perspective, addressing issues such as age, complexity, maintainability, design and technology. We wish to demonstrate that the business dimension to legacy information systems, represented by the organisation structure, business processes and procedures that are bound up in the design and operation of the existing IT systems, is also significant. This paper identifies the important role of legacy information systems in the formation of new strategies. We show that the move away from a stable to an unstable business environment accelerates the rate of change. Furthermore, the gap between what the legacy information systems can deliver and the strategic vision of the organization widens when the legacy information systems are unable to adapt to meet the new requirements. An analysis of fifteen case studies provides evidence that legacy information systems include business and technical dimensions and that the systems can present problems when there is a misalignment between the strategic vision of the business, the IT legacy and the old business model embodied in the legacy.

Psychological capital as moderator of organizational change demands on nursing stress

Healthcare organizations in all OECD countries have continued to undergo change. These changes have been found to have a negative effect on work engagement of nursing staff. While the extent to which nursing staff dealt with these changes has been documented in the literature, little is known of how they utilized their personal resources to deal with the consequences of these changes. This study will address this gap by integrating the Job Demands-Resources theoretical perspective with Positive Psychology, in particular, psychological capital (PsyCap). PsyCap is operationalized as a source of personal resources. Data were collected from 401 nurses from Australia and analyses were undertaken using Partial Least Squares modelling and moderation analysis. Two types of changes on the nursing work were identified. There was an increase in changes to the work environment of nursing. These changes, included increasing administrative workload and the amount of work, resulted in more job demands and job resources. On the other hand, another type of changes relate to reduction to training and management support, which resulted in less job demands. Nurses with more job demands utilized more job resources to address these increasing demands. We found PsyCap to be a crucial source of personal resources that has a moderating effect on the negative effects of job demands and role stress. PsyCap and job resources were both critical in enhancing the work engagement of nurses, as they encountered changes to nursing work. These findings provided empirical support for a positive psychological perspective of understanding nursing engagement.

The future Australian paramedic workforce : a snapshot of undergraduate paramedic students

Objective Describe the demographics of undergraduate paramedic students enrolled at a major Queensland University and explore the potential impact of demographic change in the paramedic workforce of the future. Method A retrospective, descriptive analysis of de-identified, routinely collected administrative data on students enrolled in the paramedic undergraduate degree program at Queensland University of Technology was undertaken for the period 2005-2013. Quantitative data were examined using the Statistical Package for Social Science version 21. Results A total of 914 students had commenced the paramedic degree since 2005, of whom slightly more than a third (33.4%; SD 9.5%) were enrolled in the double degree with nursing beginning from 2009. Half of the student cohort (52.1%;, SD 4.8%) were female, with the majority (82.9%;, SD 3.4) aged under 25 years old. Most (45.2%;, SD 13) of the student admissions were for graduate entry [i.e. prior tertiary education had been completed], while secondary education entry represented 35.9% (SD 14.9%). Conclusion By contrasting the results of our study to the most recent demographic data of the Australian paramedic workforce, a significant difference in the demographic characteristics of the current and future paramedic workforce is noted. Due to these differences, the need for increased flexibility in employment arrangements should be anticipated. This presentation will explore these characteristics and provide a complementary evidence base on which workforce planning within ambulance services can be conducted.

The Australian rise of esomeprazole - was expenditure on samples a contributor?

Background Administrative data from the Australian Pharmaceutical Benefits Scheme (PBS) showed rapid growth of esomeprazole dispensing when it was launched. Australia has universal prescription medicine coverage (the PBS), which included esomeprazole from August 2002. Free samples of new medicines are commonly provided to doctors. Objectives To determine if a relationship exists between marketing expenditure on samples and the dispensing rate for esomeprazole in Australia between June 2002 and September 2006. Methods Quarterly sample expenditures at product/brand level for proton pump inhibitors (PPIs) for Australian general practitioners were obtained for July 2002 to September 2006. Corresponding PBS dispensing data were obtained for all PPIs and converted to defined daily dose (DDD)/1000 population/day. Spending on samples was calculated as dollars per dispensed prescription and plotted against time on the Australian market. Results: Total PPI usage increased from 34.2 to 50.8 DDD/1000 population/ day over the study period. Expenditure on samples per dispensed prescription was higher when a PPI was new on the market and diminished over 5-6 years to a relatively constant level. The rapid decline in this ratio was demonstrated by a case study following esomeprazole from launch in Australia for almost 5 years clearly demonstrating the initial investment to drive sales. Conclusion A relationship appears to exist between expenditure on esomeprazole samples and its usage in Australia. A high initial investment was followed by a rapid reduction in cost per prescription dispensed, predominantly due to growth in market share. This trend was consistent with other PPIs