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

Background In many clinical areas, integrated care pathways are utilised as structured multidisciplinary care plans which detail essential steps in caring for patients with specific clinical problems. Particularly, care pathways for the dying have been developed as a model to improve the end-of-life care of all patients. They aim to ensure that the most appropriate management occurs at the most appropriate time and that it is provided by the most appropriate health professional. Clinical pathways for end-of-life care management are used widely around the world and have been regarded as the gold standard. Therefore, there is a significant need for clinicians to be informed about the utilisation of end-of-life care pathways with a systematic review. Objectives To assess the effects of end-of-life care pathways, compared with usual care (no pathway) or with care guided by another end-of-life care pathway across all healthcare settings (e.g. hospitals, residential aged care facilities, community). Search strategy The Cochrane Register of controlled Trials (CENTRAL), the Pain, Palliative and Supportive Care Review group specialised register,MEDLINE, EMBASE, review articles and reference lists of relevant articles were searched. The search was carried out in September 2009. Selection criteria All randomised controlled trials (RCTs), quasi-randomised trial or high quality controlled before and after studies comparing use versus non-use of an end-of-life care pathway in caring for the dying. Data collection and analysis Results of searches were reviewed against the pre-determined criteria for inclusion by two review authors. Main results The search identified 920 potentially relevant titles, but no studies met criteria for inclusion in the review. Authors’ conclusions Without further available evidence, recommendations for the use of end-of-life pathways in caring for the dying cannot be made. RCTs or other well designed controlled studies are needed for evaluating the use of end-of-life care pathways in caring for dying people.

Information interventions for orienting patients and their carers to cancer care facilities (Protocol)

To assess the effects of information interventions which orient patients and their carers/family to a cancer care facility and the services available in the facility.

A brush with the real world : the future of inertial motion capture in live performance

3D Motion capture is a medium that plots motion, typically human motion, converting it into a form that can be represented digitally. It is a fast evolving field and recent inertial technology may provide new artistic possibilities for its use in live performance. Although not often used in this context, motion capture has a combination of attributes that can provide unique forms of collaboration with performance arts. The inertial motion capture suit used for this study has orientation sensors placed at strategic points on the body to map body motion. Its portability, real-time performance, ease of use, and its immunity from line-of-sight problems inherent in optical systems suggest it would work well as a live performance technology. Many animation techniques can be used in real-time. This research examines a broad cross-section of these techniques using four practice-led cases to assess the suitability of inertial motion capture to live performance. Although each case explores different visual possibilities, all make use of the performativity of the medium, using either an improvisational format or interactivity among stage, audience and screen that would be difficult to emulate any other way. A real-time environment is not capable of reproducing the depth and sophistication of animation people have come to expect through media. These environments take many hours to render. In time the combination of what can be produced in real-time and the tools available in a 3D environment will no doubt create their own tree of aesthetic directions in live performance. The case study looks at the potential of interactivity that this technology offers.

National guidelines for digital modelling

These National Guidelines and Case Studies for Digital Modelling are the outcomes from one of a number of Building Information Modelling (BIM)-related projects undertaken by the CRC for Construction Innovation. Since the CRC opened its doors in 2001, the industry has seen a rapid increase in interest in BIM, and widening adoption. These guidelines and case studies are thus very timely, as the industry moves to model-based working and starts to share models in a new context called integrated practice. Governments, both federal and state, and in New Zealand are starting to outline the role they might take, so that in contrast to the adoption of 2D CAD in the early 90s, we ensure that a national, industry-wide benefit results from this new paradigm of working. Section 1 of the guidelines give us an overview of BIM: how it affects our current mode of working, what we need to do to move to fully collaborative model-based facility development. The role of open standards such as IFC is described as a mechanism to support new processes, and make the extensive design and construction information available to asset operators and managers. Digital collaboration modes, types of models, levels of detail, object properties and model management complete this section. It will be relevant for owners, managers and project leaders as well as direct users of BIM. Section 2 provides recommendations and guides for key areas of model creation and development, and the move to simulation and performance measurement. These are the more practical parts of the guidelines developed for design professionals, BIM managers, technical staff and ‘in the field’ workers. The guidelines are supported by six case studies including a summary of lessons learnt about implementing BIM in Australian building projects. A key aspect of these publications is the identification of a number of important industry actions: the need for BIM-compatible product information and a national context for classifying product data; the need for an industry agreement and setting process-for-process definition; and finally, the need to ensure a national standard for sharing data between all of the participants in the facility-development process.

National guidelines for digital modelling : case studies

These National Guidelines and Case Studies for Digital Modelling are the outcomes from one of a number of Building Information Modelling (BIM)-related projects undertaken by the CRC for Construction Innovation. Since the CRC opened its doors in 2001, the industry has seen a rapid increase in interest in BIM, and widening adoption. These guidelines and case studies are thus very timely, as the industry moves to model-based working and starts to share models in a new context called integrated practice. Governments, both federal and state, and in New Zealand are starting to outline the role they might take, so that in contrast to the adoption of 2D CAD in the early 90s, we ensure that a national, industry-wide benefit results from this new paradigm of working. Section 1 of the guidelines give us an overview of BIM: how it affects our current mode of working, what we need to do to move to fully collaborative model-based facility development. The role of open standards such as IFC is described as a mechanism to support new processes, and make the extensive design and construction information available to asset operators and managers. Digital collaboration modes, types of models, levels of detail, object properties and model management complete this section. It will be relevant for owners, managers and project leaders as well as direct users of BIM. Section 2 provides recommendations and guides for key areas of model creation and development, and the move to simulation and performance measurement. These are the more practical parts of the guidelines developed for design professionals, BIM managers, technical staff and ‘in the field’ workers. The guidelines are supported by six case studies including a summary of lessons learnt about implementing BIM in Australian building projects. A key aspect of these publications is the identification of a number of important industry actions: the need for BIMcompatible product information and a national context for classifying product data; the need for an industry agreement and setting process-for-process definition; and finally, the need to ensure a national standard for sharing data between all of the participants in the facility-development process.

A QUT experience in combining sustainability research with educational activities and professional practice

The paper discusses the development and delivery of a university subject on sustainable construction, using related research projects as case studies and learning materials. It exposed students from a variety of disciplines to real life scenarios, to group around project cases, and learn to work with one another in solving sustainable development problems. The problem based learning approach directly responds to the new trends of learning by practising which, in the area of sustainability education, is particularly appropriate because of the need for multidisciplinary approach to complex issues, and the impetus for research and development to provide timely input for education in this growing discipline with a relatively short history. Collaboration of students from cross-disciplines, the engagement of industry and practitioners, the concept of using project cases and student design competition, and the tangible improvement of students’ comprehension of the sustainability phenomenon as a whole, have been the highlights of this Australian experience.

Supply chain collaboration : capabilities for continuous innovation

Purpose – The purpose of this study is to investigate how collaborative relationships enhance continuous innovation in the supply chain using case studies. Design/methodology/approach – The data were collected from semi-structured interviews with 23 managers in ten case studies. The main intention was to comprehend how these firms engaged in collaborative relationships and their importance for successful innovation. The study adopted a qualitative approach to investigating these factors. Findings – The findings demonstrate how differing relationships can impact on the operation of firms and their capacities to innovate. The ability to work together with partners has enabled firms to integrate and link operations for increased effectiveness as well as embark on both radical and incremental innovation. Research limitations/implications – The research into the initiatives and strategies for collaboration was essentially exploratory. A qualitative approach using case studies acknowledged that the responses from managers were difficult to quantify or gauge the extent of these factors. Practical implications – The findings have shown various methods where firms integrated with customers and suppliers in the supply chain. This was evident in the views of managers across all the firms examined, supporting the importance of collaboration and efficient allocation of resources throughout the supply chain. They were able to set procedures in their dealings with partners, sharing knowledge and processes, and subsequently joint-planning and investing with them for better operations, systems and processes in the supply chain. Originality/value – The case studies serve as examples for managers in logistics organisation who are contemplating strategies and issues on collaborative relationships. The study provides important lessons on how such relationships can impact on the operation of firms and their capability to innovate. Keywords Supply chain management, Innovation, Relationship marketing

Performance Research in Rangeland Communities

In 2003, Bill Dunstone, John McCallum and Paul Makeham began a collaboration with researchers at the Centre for the Management of Arid Environments (CMAE) in Kalgoorlie, Western Australia. CMAE researchers are keen to develop 'people-oriented' strategies for implementing agricultural extension initiatives in their region. Traditional hierarchies of knowledge-transfer have impeded the 'connectedness' between community and researchers that gives meaning and relevance to useful practice (Ison and Russell, 2000). Our aim is to establish a partnership between the Live Events Research Network (LERN) and CMAE, investigating ways to link creative, performance-based research and practice with the scientific methodologies associated with natural resources management. This accords with recent work undertaken by Deborah Mills and Paul Brown, showing how community cultural development strategies enhance the implementation of policy concerned with community wellbeing. Mills and Brown 'adopted a concept of wellbeing which builds on a social and environmental view of health', and considered such themes as ecological sustainability, rural economic revitalisation, community strengthening, health and wellbeing (Mills, 2003). We propose that rangeland communities can creatively manage some of the challenges confronting them through performance-based projects which: - activate the stories through which a community enacts its sense of place; - facilitate live events in which the community enacts ownership of its culture and identity; - directly involve the community in the formulation of research issues

Towards authorisation models for secure information sharing : a survey and research agenda

This article presents a survey of authorisation models and considers their ‘fitness-for-purpose’ in facilitating information sharing. Network-supported information sharing is an important technical capability that underpins collaboration in support of dynamic and unpredictable activities such as emergency response, national security, infrastructure protection, supply chain integration and emerging business models based on the concept of a ‘virtual organisation’. The article argues that present authorisation models are inflexible and poorly scalable in such dynamic environments due to their assumption that the future needs of the system can be predicted, which in turn justifies the use of persistent authorisation policies. The article outlines the motivation and requirement for a new flexible authorisation model that addresses the needs of information sharing. It proposes that a flexible and scalable authorisation model must allow an explicit specification of the objectives of the system and access decisions must be made based on a late trade-off analysis between these explicit objectives. A research agenda for the proposed Objective-based Access Control concept is presented.

How can flexible learning centres use social networking to improve their ongoing educational assessments?

Most online assessment systems now incorporate social networking features, and recent developments in social media spaces include protocols that allow the synchronisation and aggregation of data across multiple user profiles. In light of these advances and the concomitant fear of data sharing in secondary school education this papers provides important research findings about generic features of online social networking, which educators can use to make sound and efficient assessments in collaboration with their students and colleagues. This paper reports on a design experiment in flexible educational settings that challenges the dichotomous legacy of success and failure evident in many assessment activities for at-risk youth. Combining social networking practices with the sociology of education the paper proposes that assessment activities are best understood as a negotiable field of exchange. In this design experiment students, peers and educators engage in explicit, "front-end" assessment (Wyatt-Smith, 2008) to translate digital artefacts into institutional, and potentiality economic capital without continually referring to paper based pre-set criteria. This approach invites students and educators to use social networking functions to assess “work in progress” and final submissions in collaboration, and in doing so assessors refine their evaluative expertise and negotiate the value of student’s work from which new criteria can emerge. The mobile advantages of web-based technologies aggregate, externalise and democratise this transparent assessment model for most, if not all, student work that can be digitally represented.

Matching intention with agency : lessons from practice

The research project described in this paper was designed to explore the potential of a wiki to facilitate collaboration and to reduce the isolation of postgraduate students enrolled in a professional doctoral program at a Queensland university. It was also intended to foster a community of practice for reviewing and commenting on one another’s work despite the small number of students and their disparate topics. The students were interviewed and surveyed at the beginning and during the face-to-face sessions of the course and their wikis were examined over the year to monitor, analyse and evaluate the extent to which the agency of the technology (wiki) mediated their development of scholarly skills. The study showed that students paradoxically eschewed use of the structured wiki and formed their own informal networks. This paper will contend that this paradox arose from a mismatch between the agency of technology and its intended purpose.

The planning of airport regions and National Aviation Policy Issues and challenges in the Australian experience 2008-2009

The planning of airports has long been contentious because of their localisation of negative impacts. The globalisation, commercialisation and deregulation of the aviation industry has unleashed powerful new economic forces both on and offairport. Over the last two decades, many airports have evolved into airport cities located at the heart of the wider aerotropolis region. This shifts the appropriate scale of planning analysis towards broader regional concerns. However,governments have been slow to respond and airport planning usually remains poorly integrated with local, city and regional planning imperatives. The Australian experience exemplifies the divide. The privatization of major Australian airports from 1996 has seen billions of dollars spent on new airside and landside infrastructure but with little oversight from local and state authorities because the ultimate authority for on-airport development is the Federal Minister for Transport. Consequently, there have been growing tensions in many major airport regions between the private airport lessee and the broader community, exacerbated by both the building of highly conspicuous non-aeronautical developments and growing airport area congestion. This paper examines the urban planning content of Australia’s national aviation policy review (2008-09) with reference to current and potential opportunities for all-of-region collaboration in the planning process.

Building the toolkit of quality monitoring clinical outcomes as a means of assessing quality in residential care

Residential aged care in Australia does not have a system of quality assessment related to clinical outcomes, creating a significant gap in quality monitoring. Clinical outcomes represent the results of all inputs into care, thus providing an indication of the success of those inputs. To fill this gap, an assessment tool based on resident outcomes (the ResCareQA) was developed and evaluated in collaboration with residential care providers. A useful output of the ResCareQA is a profile of resident clinical status, and this paper will use such outputs to present a snapshot of nine residential facilities. Such comprehensive data has not yet been available within Australia, so this will provide an important insight. ResCareQA data was collected from all residents (N=498) of nine aged care facilities from two major aged care providers. For each facility, numerator–denominator data were calculated to assess the degree of potential clinical problems. Results varied across clinical areas and across facilities, and rank-ordered facility results for selected clinical areas are reviewed and discussed. Use of the ResCareQA to generate clinical outcome data provides a concrete means of monitoring care quality within residential facilities; regular use of the ResCareQA could thus contribute to improved care outcomes within residential aged care.

MiLK. Mobile Learning Kit

The Mobile Learning Kit is a new digital learning application that allows students and teachers to compose, publish, discuss and evaluate their own mobile learning games and events. The research field was interaction design in the context of mobile learning. The research methodology was primarily design-based supported by collaboration between participating disciplines of game design, education and information technology. As such, the resulting MiLK application is a synthesis of current pedagogical models and experimental interaction design techniques and technologies. MiLK is a dynamic learning resource for incorporating both formal and informal teaching and learning practices while exploiting mobile phones and contemporary digital social tools in innovative ways. MiLK explicitly addresses other predominant themes in educational scholarship that relate to current education innovation and reform such as personalised learning, life-long learning and new learning spaces. The success of this project is indicated through rigorous trials and actual uptake of MiLK by international participants in Australia, UK, US and South Africa. MiLK was awarded for excellence in the use of emerging technologies for improved learning and teaching as a finalist (top 3) in the Handheld Learning and Innovation Awards in the UK in 2008. MiLK was awarded funding from the Australasian CRC for Interaction Design in 2008 to prepare the MiLK application for development. MiLK has been awarded over $230,000 from ACID since 2006. The resulting application and research materials are now being commercialised by a new company, ‘ACID Services’.