A dedicated retrieval and transfer service : the QUARTS project

Background The transfer and/or retrieval of a critically patient is inherently dangerous not only for the patient but for staff as well. The quality and experience of unplanned transfers can influence patient mortality and morbidity. However, international evidence suggests that dedicated transfer/retrieval teams can improve mortality and morbidity outcomes. Aims The initial aim of this paper is to describe an in-house competency-based training programme, which encompasses the STaR approach to develop members of our existing nursing team to be part of the dedicated transfer/retrieval service. The paper also presents audit data findings which examined the source of referrals, number of patients actually transferred and clinical status of those being transferred. Results Audit data illustrate that the most frequent source of referrals comes from Accident and Emergency and the Surgical Directorate with the most common presenting condition being cardio-respiratory failure or arrest. Audit data reveal that the number of patients actually transferred or retrieved is relatively small (33%) compared with the overall number of requests for assistance. However, 36% of those patients transferred had a level 2 or level 3 acuity status that necessitated the admission to a critical care area. Conclusions A number of studies have concluded that the ill-experienced and ill-equipped transfer team can place patients’ at serious risk of harm. Whether planned or unplanned, dedicated critical care transfer/retrieval teams have been shown to reduce patient mortality and morbidity.

Mesenchymal stem cells, neural lineage potential, heparan sulfate proteoglycans and the matrix

Along with the tri-lineage of bone, cartilage and fat, human mesenchymal stem cells (hMSCs) retain neural lineage potential. Multiple factors have been described that influence lineage fate of hMSCs including the extracellular microenvironment or niche. The niche includes the extracellular matrix (ECM) providing structural composition, as well as other associated proteins and growth factors, which collectively influence hMSC stemness and lineage specification. As such, lineage specific differentiation of MSCs is mediated through interactions including cell–cell and cell–matrix, as well as through specific signalling pathways triggering downstream events. Proteoglycans (PGs) are ubiquitous within this microenvironment and can be localised to the cell surface or embedded within the ECM. In addition, the heparan sulfate (HS) and chondroitin sulfate (CS) families of PGs interact directly with a number of growth factors, signalling pathways and ECM components including FGFs, Wnts and fibronectin. With evidence supporting a role for HSPGs and CSPGs in the specification of hMSCs down the osteogenic, chondrogenic and adipogenic lineages, along with the localisation of PGs in development and regeneration, it is conceivable that these important proteins may also play a role in the differentiation of hMSCs toward the neuronal lineage. Here we summarise the current literature and highlight the potential for HSPG directed neural lineage fate specification in hMSCs, which may provide a new model for brain damage repair.

Social media and tacit knowledge sharing : physicians' perspectives and experiences

Tacit knowledge sharing amongst physicians is known to have a significant impact on the quality of medical decisions. This thesis posits that social media can provide new opportunities for tacit knowledge sharing amongst physicians, and demonstrates this by presenting findings from a review of relevant literature and a qualitative survey conducted with physicians. Using thematic analysis, the study revealed five major themes and over twenty sub-themes as potential contributions of social media to tacit knowledge flow amongst physicians.

Developing intercultural understanding through Asian-Australian children’s literature.

This PETAA paper discusses how the cross-curriculum priority concerned with developing Asia literacy, namely ‘Asia and Australia’s engagement with Asia’, can be significantly advanced through the study of children’s literature. The discussion proceeds from a brief overview of the historical development of Asia literacy to its current place within the Australian Curriculum. It then considers the potential of literature for assisting students and teachers in realising this priority through the Asian-Australian Children’s Literature and Publishing dataset, a research project on AustLit. Finally, it discusses a small selection of texts – two picture books and a novel – with suggestions or prompts for raising students’ intercultural understanding.

Building sensitising terms to understand free-play in open-ended interactive art environments

In this paper we introduce and discuss the nature of free-play in the context of three open-ended interactive art installation works. We observe the interaction work of situated free-play of the participants in these environments and, building on precedent work, devise a set of sensitising terms derived both from the literature and from what we observe from participants interacting there. These sensitising terms act as guides and are designed to be used by those who experience, evaluate or report on open-ended interactive art. That is, we propose these terms as a common-ground language to be used by participants communicating while in the art work to describe their experience, by researchers in the various stages of research process (observation, coding activity, analysis, reporting, and publication), and by inter-disciplinary researchers working across the fields of HCI and art. This work builds a foundation for understanding the relationship between free-play, open-ended environments, and interactive installations and contributes sensitising terms useful for the HCI community for discussion and analysis of open-ended interactive art works.

"The Stratified Record upon Which We Set Our Feet" : The Spatial Turn and the Multilayering of History, Geography, and Geology

In Thomas Mann’s tetralogy of the 1930s and 1940s, Joseph and His Brothers, the narrator declares history is not only “that which has happened and that which goes on happening in time,” but it is also “the stratified record upon which we set our feet, the ground beneath us.” By opening up history to its spatial, geographical, and geological dimensions Mann both predicts and encapsulates the twentieth-century’s “spatial turn,” a critical shift that divested geography of its largely passive role as history’s “stage” and brought to the fore intersections between the humanities and the earth sciences. In this paper, I draw out the relationships between history, narrative, geography, and geology revealed by this spatial turn and the questions these pose for thinking about the disciplinary relationship between geography and the humanities. As Mann’s statement exemplifies, the spatial turn itself has often been captured most strikingly in fiction, and I would argue nowhere more so than in Graham Swift’s Waterland (1983) and Anne Michaels’s Fugitive Pieces (1996), both of which present space, place, and landscape as having a palpable influence on history and memory. The geographical/geological line that runs through both Waterland and Fugitive Pieces continues through Tim Robinson’s non-fictional, two-volume “topographical” history Stones of Aran. Robinson’s Stones of Aran—which is not history, not geography, and not literature, and yet is all three—constructs an imaginative geography that renders inseparable geography, geology, history, memory, and the act of writing.

Never-Never Land : affective landscapes, the touristic gaze and heterotopic space in Australia

This article explores how the imaginative use of the landscape in Baz Luhrmann’s Australia (2008) intersects with the fantasy of Australianness that the film constructs. We argue the fictional Never-Never Land through which the film’s characters travel is an, albeit problematic, ‘indigenizing’ space that can be entered imaginatively through cultural texts including poetry, literature and film, or through cultural practices including touristic pilgrimages to landmarks such as Uluru and Kakadu National Park. These actual and virtual journeys to the Never-Never have broader implications in terms of fostering a sense of belonging and legitimating white presence in the land through affect, nostalgia and the invocation of an imagined sense of solidarity and community. The heterotopic concept of the Never-Never functions to create an ahistorical, inclusive space that grounds diverse conceptions of Australianness in a shared sense of belonging and home that is as mythical, contradictory and wondrous as the idea of the Never-Never itself. The representations of this landscape and the story of the characters that traverse it self-consciously construct a relationship to past events and to film history, as well as constructing a comfortable subject position for contemporary Australians to occupy in relation to the land, the colonial past, and the present.

Deleuze and music : a creative approach to the study of music

The work of Gilles Deleuze has influenced an increasing number of music scholars and practicing musicians, particularly those interested in experimental, electronic and popular music. This is despite the notoriously complex nature of his writings, and the specialised theoretical vocabulary that he employs. This thesis both demystifies some of the key terms and concepts of this vocabulary, before demonstrating how Deleuze’s ideas may be put to work in new and fruitful ways; this is achieved with specific reference to the relationships that music has with thought, time and machines. In Chapter 1, Deleuze’s understanding of the power of thought is examined, in particular his approach to communication, transcendence and immanence, and the “powers of thought.” Each of these concepts helps us to understand Deleuze’s work within broad problem of how to think about music immanently: that is, how to maintain that thought and music are both immanent aspects of life and experience. Chapter 2 examines time within a Deleuzian framework, linking his work on cinema with the concept of the “refrain”; both of these areas prove crucial to his understanding of music, as seen in Deleuze’s approach to the work of Varese, Messiaen, and Boulez. In addition, Deleuze’s understanding of time proves fruitful in examining various aspects of music production, as seen in contemporary electronic dance music. Finally, Chapter 3 looks at the concept of the machine, as developed by Deleuze and Guattari, with reference to the sorts of “machinic” connections that a Deleuzian approach encourages us to seek out in music. Once again, examples from contemporary electronic music are presented, in relation to the notions of becoming and subjectivity. Throughout these chapters, Deleuze’s broad understanding of philosophy as the “creation of concepts” is deployed. This means introducing new ideas and specific types of music that encourage creative and novel engagements with the study of music.

Everything you do : young adult fiction and surveillance in an age of security

Espionage, surveillance and clandestine operations by secret agencies and governments were something of an East–West obsession in the second half of the twentieth century, a fact reflected in literature and film. In the twenty-first century, concerns of the Cold War and the threat of Communism have been rearticulated in the wake of 9/11. Under the rubric of ‘terror’ attacks, the discourses of security and surveillance are now framed within an increasingly global context. As this article illustrates, surveillance fiction written for young people engages with the cultural and political tropes that reflect a new social order that is different from the Cold War era, with its emphasis on spies, counter espionage, brainwashing and psychological warfare. While these tropes are still evident in much recent literature, advances in technology have transformed the means of tracking, profiling and accumulating data on individuals’ daily activities. Little Brother, The Hunger Games and Article 5 reflect the complex relationship between the real and the imaginary in the world of surveillance and, as this paper discusses, raise moral and ethical issues that are important questions for young people in our age of security.

Understanding chromosome disorders and their implications for special educators

More children are now being diagnosed with chromosome abnormalities. Some chromosome disorder syndromes are relatively well known; while others are so rare that there is only limited evidence about their likely impact on learning and development. For educators, a basic level of knowledge about chromosome abnormalities is important for understanding the literature and communicating with families and professionals. This paper describes chromosomes, and the numerical and structural anomalies that can occur, usually spontaneously during early cell division. Distinctive features of various chromosome syndromes are summarised before a discussion of the rare chromosome disorders that are labelled, not with a syndrome name, but simply by a description of the chromosome number, size and shape. Because of the potential within-group variability that characterises syndromes, and the scarcity of literature about the rare chromosome disorders, expectations for learning and development of individual students need to be based on the range of possible outcomes that may be achievable.

Raising levels of awareness of rights and obligations in the provision of financial product advice to retail clients

In September-December 2012, 548 financial planning retail clients and 77 financial advisers responded to online surveys addressing consumer satisfaction with financial planning services and the provision of information concerning regulatory and rights issues. Retail clients commented on areas related to the best interests duty in s 961B of the Corporations Act 2001 (Cth), in particular the extent to which advisers considered their clients’ financial objectives and lifestyle situations, and the client-centredness of the financial advice they received. Retail clients also indicated their level of awareness of their substantive rights in relation to receiving advice, the legal obligations imposed on advisers, and whether they would access internal and external complaints processes if warranted. Advisers reported on the extent to which they provide clients with information relating to their substantive rights, and complaints processes available to them. Responses were analysed in relation to client demographics (e.g., age, gender, education), and experience of financial advice. This article reports on the findings of the surveys and their implications for financial planners.

Outsourcing income tax returns : convenient and/or controversial

This paper investigates the outsourcing of income tax return preparation by Australian accounting firms. It identifies the extent to which firms are currently outsourcing accounting services or considering outsourcing accounting services, with a focus on personal and business income tax return preparation. The motivations and barriers for outsourcing by Australian accounting firms are also considered in this paper. Privacy, security of client data, and the competence of the outsourcing provider's staff have been identified as risks associated with outsourcing. An expectation relating to confidentiality of client data is also examined in this paper. Statistical analysis of data collected from a random sample of Australian accounting firms using a survey questionnaire provided the empirical data for the paper. The results indicate that the majority of Australian accounting firms are either currently outsourcing or considering outsourcing accounting services, and firms are outsourcing taxation preparation both onshore and offshore. The results also indicate that firms expect the volume of outsourced work to increase in the future. In contrast to the literature identifying labour arbitrage as the primary driver for organisations choosing to outsource, this study found that the main factors considered by accounting firms in the decision to outsource were to expedite delivery of services to clients and to enable the firm to focus on core competencies. Data from this study also supports the literature which ndicates that not all tax practitioners are adhering to codes of conduct in relation to client confidentiality. Research identifying the extent to which accounting services are outsourced is limited, therefore significant contributions to the academic literature and the accounting profession are provided by this ndicates that not all tax practitioners are adhering to codes of conduct in relation to client confidentiality. Research identifying the extent to which accounting services are outsourced is limited, therefore significant contributions to the academic literature and the accounting profession are provided by this study.

The effect of multiplayer dynamic difficulty adjustment on the player experience of video games

Multiplayer Dynamic Difficulty Adjustment (mDDA) is a method of reducing the difference in player performance and subsequent challenge in competitive multiplayer video games. As a balance of between player skill and challenge experienced is necessary for optimal player experience, this experimental study investigates the effects of mDDA and awareness of its presence on player performance and experience using subjective and biometric measures. Early analysis indicates that mDDA normalizes performance and challenge as expected, but awareness of its presence can reduce its effectiveness.

Contribution of industry-based student learning performance for the STEM education

We hypothesized that Industry based learning and teaching, especially through company assigned student projects or training programs, is an integral part of science, technology, engineering and mathematics (STEM) education. In this paper we show that industry-based student training and experience increases students’ academic performances independent to the organizational parameters and contexts. The literature on industry-based student training focuses on employability and the industry dimension, and neglects in many ways the academic dimension. We observed that the association factors between academic attributes and contributions of industry-based student training are central and vital to the technological learning experiences. We explore international initiatives and statistics collected of student projects in two categories: Industry based learning performances and on campus performances. The data collected were correlated to five (5) universities in different industrialized countries, e.g., Australia N=545 projects, Norway N=279, Germany N=74, France N=107 and Spain N=802. We analyzed industry-based student training along with company assigned student projects compared with in comparisons to campus performance. The data that suggests a strong correlation between industry-based student training per se and improved performance profiles or increasing motivation shows that industry-based student training increases student academic performance independent of organizational parameters and contexts. The programs we augmented were orthogonal to each other however, the trend of the students’ academic performances are identical. An isolated cohort for the reported countries that opposed our hypothesis warrants further investigation.

Assessing capacity in the context of testamentary, enduring power of attorney, and advance care directive documents in Australia

Balancing the competing interests of autonomy and protection of individuals is an escalating challenge confronting an ageing Australian population. Legal and medical professionals are increasingly being asked to determine whether individuals are legally capable to make their own testamentary, financial and/or personal/health care decisions. Diseases such as dementia impact upon cognition which necessitates collaboration between the legal and medical professions to satisfactorily assess the effect of such mentally disabling conditions upon legal competency. Terminological and methodological differences exist between the two professions when assessing capacity in this context which subsequently create miscommunication and misunderstanding. Consequently, it is not necessarily a simple solution for a legal professional to seek the opinion of a medical practitioner. Exacerbating the situation is the fact that no consistent and transparent capacity assessment paradigm currently exists in Australia. Assessments are instead being undertaken on an ad hoc basis dependent upon the skill set of the legal and/or medical professionals involved. A qualitative study seeking the views of legal and medical professionals who practise in this area has been conducted. This incorporated a review of the relevant literature and surveys which informed the semi-structured interviews conducted with 10 legal and 20 medical practitioners. Practitioners were asked whether there is a standard approach to assessment and whether national guidelines would assist. The general consensus was that uniform guidelines would be advantageous. The research also canvassed practitioner views as to the state of the relationship between the professions when assessing capacity. Three promising practices have emerged from this research: first, is the need for the development of national guidelines and supporting principles to satisfactorily assess capacity; second, is the possibility of strengthening the relationship between legal and medical professionals to assist in the satisfactory assessment of legal capacity; and third, the need for increased community education.