Testing times for the implementation of curriculum change: Analysis and extension of a curriculum change model

School curriculum change processes have traditionally been managed internally. However, in Queensland, Australia, as a response to the current high-stakes accountability regime, more and more principals are outsourcing this work to external change agents (ECAs). In 2009, one of the authors (a university lecturer and ECA) developed a curriculum change model (the Controlled Rapid Approach to Curriculum Change (CRACC)), specifically outlining the involvement of an ECA in the initiation phase of a school’s curriculum change process. The purpose of this paper is to extend the CRACC model by unpacking the implementation phase, drawing on data from a pilot study of a single school. Interview responses revealed that during the implementation phase, teachers wanted to be kept informed of the wider educational context; use data to constantly track students; relate pedagogical practices to testing practices; share information between departments and professional levels; and, own whole school performance. It is suggested that the findings would be transferable to other school settings and internal leadership of curriculum change. The paper also strikes a chord of concern – Do the responses from teachers operating in such an accountability regime live their professional lives within this corporate and globalised ideology whether they want to or not?

A nationwide web-based automated system for early outbreak detection and rapid response in China

Timely reporting, effective analyses and rapid distribution of surveillance data can assist in detecting the aberration of disease occurrence and further facilitate a timely response. In China, a new nationwide web-based automated system for outbreak detection and rapid response was developed in 2008. The China Infectious Disease Automated-alert and Response System (CIDARS) was developed by the Chinese Center for Disease Control and Prevention based on the surveillance data from the existing electronic National Notifiable Infectious Diseases Reporting Information System (NIDRIS) started in 2004. NIDRIS greatly improved the timeliness and completeness of data reporting with real time reporting information via the Internet. CIDARS further facilitates the data analysis, aberration detection, signal dissemination, signal response and information communication needed by public health departments across the country. In CIDARS, three aberration detection methods are used to detect the unusual occurrence of 28 notifiable infectious diseases at the county level and to transmit that information either in real-time or on a daily basis. The Internet, computers and mobile phones are used to accomplish rapid signal generation and dissemination, timely reporting and reviewing of the signal response results. CIDARS has been used nationwide since 2008; all Centers for Disease Control and Prevention (CDC) in China at the county, prefecture, provincial and national levels are involved in the system. It assists with early outbreak detection at the local level and prompts reporting of unusual disease occurrences or potential outbreaks to CDCs throughout the country.

Where do ED patients come from?

A lack of access to primary care services, decreasing numbers of general practitioners (GPs) and free of charge visits have been cited as factors contributing to the rising demand on emergency departments. This study aims to investigate the sources of patients' referrals to emergency departments and track changes in the source of referral over a six-year period in Queensland. Data from Queensland Emergency Departments Information Systems were analyzed based on records from 21 hospitals for the periods 2003–04 to 2008–09. The emergency department data were compared with publicly available data on GPs services and patients attendance rates. In Queensland, the majority of patients are self-referred and a 6.6% growth between 2003–04 and 2008–09 (84.4% to 90% respectively) has been observed. The number of referrals made by GPs, hospitals and community services decreased by 29.4%, 40%, 42% respectively during the six-year period. The full-time workload equivalent GPs per 100,000 people increased by 4.5% and the number of GP attendances measured per capita rose by 4% (4.25 to 4.42). An examination of changes in the triage category of self-referred patients revealed an increase in triage category 1-3 by 60%, 36.2%, and 14.4% respectively. The number of self-referred patients in triage categories 4–5 decreased by 10.5% and 21.9% respectively. The results of this analysis reveal that although the number of services provided by GPs increased, the amount of referrals decreased, and the proportion of self-referred patients to emergency departments rose during the six-year period. In addition, a growth in urgent triage categories (1–3) has been observed, with a decline in the number of non-urgent categories (4–5) among patients who came directly to emergency departments. Understanding the reasons behind this situation is crucial for appropriate demand management. Possible explanations will be sought and presented based on patients' responses to an emergency department users' questionnaire.

Re-thinking sustainable solutions: Innovation inspired by nature

Australian rural landscapes are facing a crisis from land degradation due to rising salinity levels, soil acidification and soil erosion. There is growing consensus amongst the businesses community, government departments and research organisations that the real solution to these problems and the broader sustainability dilemma comes by taking a ‘whole of system’ approach to agricultural and rangelands management. This article introduces two cutting-edge concepts – Biomimicry and Natural Sequence Farming – to illustrate how whole-system thinking can effectively and profitably address the challenges facing agriculture and rangelands.

Making the profitable transition towards sustainable business practice

The last three decades have been difficult for companies and industry. In an increasingly competitive international business climate with shifting national environmental regulations, higher standards are being demanded by the consumer and community groups, not-to-mention the escalating cost of primary resources such as water, steel and minerals. The cause of these pressures is the traditional notion held by business executives and engineers that there is an inherent trade off between eco-efficiency and improving the economic bottom line. However there is significant evidence and examples of best practice to show that there is in fact no trade-off between the environment and the economy if sustainable development through continual improvement is adopted. It is highly possible therefore for companies to make a profitable transition towards sustainable business practice, where along the transition significant business opportunities can be taken advantage of. Companies are by their very nature dynamic, influential and highly capable of adapting to change. Making an organisational transformation to a sustainable business is not outside the capacity of the typical company, who know much of what is needed already to change their activities to satisfy current market demands while achieving competitiveness. However in order to make the transition towards sustainable business practice companies require some key mechanisms such as accurate information on methodologies and opportunities, understanding of the financial and non-financial incentives, permission from stakeholders and shareholders, understanding of the emerging market opportunities, a critical mass of leaders in their sector and demonstrated case studies, and awarding appropriate risk-taking activities undertaken by engineers and CEOs. Satisfying these requirements will adopt an innovative culture within the company that strives for continual improvement and successfully transforms itself to achieve competitiveness in the 21st Century. This paper will summarise the experiences of The Natural Edge Project (TNEP) and its partners in assisting organisations to make a profitable transition towards sustainable business practice through several initiatives. The Natural Advantage of Nations publication provides the critical information required by business leaders and engineers to set the context of sustainable business practice. The Profiting in a Carbon Constrained World report, developed with Natural Capitalism Inc led by Hunter Lovins, summarises the opportunities available to companies to take advantage of the carbon trading market mechanisms such as the Chicago Climate Exchange and European Climate Exchange. The Sustainability Helix then guides the company through the transition by identifying the key tools and methodologies required by companies to reduce environmental loading while dramatically improving resource productivity and achieving competitiveness. Finally, the Engineering Sustainable Solutions Program delivers the key engineering information required by companies and university departments to deliver sustainable engineering solutions. The initiatives are of varying complexity and level of application, however all are designed to provide key staff the critical information required to make a profitable transition towards sustainable business practice. It is then their responsibility to apply and teach their knowledge to the rest of the organisation.

Risk factors for hospital re-presentation among older adults following fragility fractures: Protocol for a systematic review

Background After being discharged from hospital following the acute management of a fragility fracture, older adults may re-present to hospital emergency departments in the post-discharge period. Early re-presentation to hospital, which includes hospital readmissions, and emergency department presentations without admission, may be considered undesirable for individuals, hospital institutions and society. The identification of modifiable risk factors for hospital re-representation following initial fracture management may prove useful for informing policy or practice initiatives that seek to minimise the need for older adults to re-present to hospital early after they have been discharged from their initial inpatient care. The purpose of this systematic review is to identify correlates of hospital re-presentation in older patients who have been discharged from hospital following clinical management of fragility fractures. Methods/Design The review will follow the PRISMA-P reporting guidelines for systematic reviews. Four electronic databases (Pubmed, CINAHL, Embase, and Scopus) will be searched. A suite of search terms will identify peer-reviewed articles that have examined the correlates of hospital re-presentation in older adults (mean age of 65 years or older) who have been discharged from hospital following treatment for fragility fractures. The Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies will be used to assess the quality of the studies. The strength of evidence will be assessed through best evidence synthesis. Clinical and methodological heterogeneity across studies are likely to impede meta-analyses. Discussion The best evidence synthesis will outline correlates of hospital re-presentations in this clinical group. This synthesis will take into account potential risks of bias for each study, while permitting inclusion of findings from a range of quantitative study designs. It is anticipated that findings from the review will be useful in identifying potentially modifiable risk factors that have relevance in policy, practice and research priorities to improve the management of patients with fragility fractures. Systematic Review Registration PROSPERO CRD42015019379

Innovation in energy efficiency education for engineers

Energy efficiency as a concept has gained significant attention over the last few decades, as governments and industries around the world have grappled with issues such as rapid population growth and expanding needs for energy, the cost of supplying infrastructure for growing spikes in peak demand, the finite nature of fossil based energy reserves, and managing transition timeframes for expanding renewable energy supplies. Over the last decade in particular, there has been significant growth in understanding the complexity and interconnectedness of these issues, and the centrality of energy efficiency to the engineering profession. Furthermore, there has been a realisation amongst various government departments and education providers that associated knowledge and skill sets to achieve energy efficiency goals are not being sufficiently developed in vocational or higher education. Within this context, this poster discusses the emergence of a national energy efficiency education agenda in Australia, to support embedding such knowledge throughout the engineering curriculum, and throughout career pathways. In particular, the posterprovides insights into the national priorities for capacity building in Australia, and how this is influencing the engineering education community, from undergraduate education through to postgraduate studies and professional development. The poster is intended to assist in raising awareness about the central role of energy efficiency within engineering, significant initiatives by major government, professional, and training organisations, and the increasing availability of high quality energy efficiency engineering education resources. The authors acknowledge the support for and contributions to this poster by the federal Department of Resources, Energy and Tourism, through members of the national Energy Efficiency Advisory Group for engineering education.

Predicting the need for adaptive radiotherapy in head and neck cancer

Background and purpose Adaptive radiotherapy (ART) can account for the dosimetric impact of anatomical change in head and neck cancer patients; however it can be resource intensive. Consequently, it is imperative that patients likely to require ART are identified. The purpose of this study was to find predictive factors that identify oropharyngeal squamous cell carcinoma (OPC) and nasopharyngeal carcinoma (NPC) patients more likely to need ART. Materials and methods One hundred and ten patients with OPC or NPC were analysed. Patient demographics and tumour characteristics were compared between patients who were replanned and those that were not. Factors found to be significant were included in logistic regression models. Risk profiles were developed from these models. A dosimetric analysis was performed. Results Nodal disease stage, pre-treatment largest involved node size, diagnosis and initial weight (categorised in 2 groups) were identified as significant for inclusion in the model. Two models were found to be significant (p = 0.001), correctly classifying 98.2% and 96.1% of patients respectively. Three ART risk profiles were developed. Conclusion Predictive factors identifying OPC or NPC patients more likely to require ART were reported. A risk profile approach could facilitate the effective implementation of ART into radiotherapy departments through forward planning and appropriate resource allocation.

Mandatory Reporting Laws and the Identification of Severe Child Abuse and Neglect

This book provides the first comprehensive international coverage of key issues in mandatory reporting of child abuse and neglect. The book draws on a collection of the foremost scholars in the field, as well as clinicians and practice-based experts, to explore the nature, history, impact and justifiability of mandatory reporting laws, their optimal form, legal and conceptual issues, and practical issues and challenges for reporters, professional educators and governments. Key issues in non-Western nations are also explored briefly to assess the potential of socio-legal responses sex trafficking, forced child labour and child marriage. The book is of particular value to policy makers, educators and opinion leaders in government departments dealing with children, and to professionals and organisations who work with children. It is also intended to be a key authority for researchers and teachers in the fields of medicine, nursing, social work, education, law, psychology, health and allied health fields.

The role of marketing in today's enterprises

Purpose The purpose of this paper is to explore the role of marketing in today's enterprises and examines the antecedents of the marketing department's influence and its relationship with market orientation and firm performance. Design/methodology/approach Data were collected from the West (i.e. the USA and Europe) and the East (i.e. Asia). Partial least squares (PLS) was used to estimate structural models. Findings The findings support the idea that a strong and influential marketing department contributes positively to firm performance. This finding holds for Western and Asian, and for small/medium and large firms alike. Second, the marketing department's influence in a firm depends more on its responsibilities and resources, and less on internal contingency factors (i.e. a firm's competitive strategy or institutional attributes). Third, a marketing department's influence in the West affects firm performance both directly and indirectly (via market orientation). In contrast, this relationship is fully mediated among Eastern firms. Fourth, low-cost strategies enhance the influence of a firm's marketing department in the East, but not in the West. Research limitations/implications The paper assumes explicitly that a marketing department's influence is an antecedent of its market orientation. While the paper finds support for this link, the paper did not test for dual causality between the constructs. Originality/value Countering the frequent claim in anecdotal and journalistic work that the role of the marketing department diminishes, the findings show that across different geographic regions and firm sizes, strong marketing departments improve firm performance (especially in the marketing-savvy West), and that they should continue to play an important role in firms.

Projecting excess emergency department visits and associated costs in Brisbane, Australia, under population growth and climate change scenarios

The direct and indirect health effects of increasingly warmer temperatures are likely to further burden the already overcrowded hospital emergency departments (EDs). Using current trends and estimates in conjunction with future population growth and climate change scenarios, we show that the increased number of hot days in the future can have a considerable impact on EDs, adding to their workload and costs. The excess number of visits in 2030 is projected to range between 98–336 and 42–127 for younger and older groups, respectively. The excess costs in 2012–13 prices are estimated to range between AU$51,000–184,000 (0–64) and AU$27,000–84,000 (65+). By 2060, these estimates will increase to 229–2300 and 145–1188 at a cost of between AU$120,000–1,200,000 and AU$96,000–786,000 for the respective age groups. Improvements in climate change mitigation and adaptation measures are likely to generate synergistic health co-benefits and reduce the impact on frontline health services.

Academic entrepreneurship: A multilevel examination of individual, subunit and organizational effects

This study utilizes a multilevel approach to both estimate the relative importance of individual, subunit, and organization effects on entrepreneurial intentions in academia, as well as to investigate specific factors within the subunit effect and their interactions with other levels. Using a dataset of 2,652 researchers from 386 departments in 24 European universities, our findings reveal that intra-university differences, caused by the influence of the department, should not be ignored when studying academic entrepreneurship. Whereas researchers’ entrepreneurial intentions are mostly influenced by individual differences, department membership explains more variation than the university as a whole. Furthermore, drawing upon organizational culture literature, we identify a department’s adhocracy culture, characterized by flexibility and an external orientation, to be positively related to entrepreneurial intentions. Finally, consistent with trait activation theory, we find that strong adhocracy cultures reinforce the positive association between proactive personality and entrepreneurial intentions. This effect is further intensified when the university also has a technology transfer office with a substantial size. Our results have relevant implications for both academics and practitioners, including university managers, department heads and policy makers.

Overcoming language barriers in healthcare: A protocol for investigating safe and effective communication when patients or clinicians use a second language

Background Miscommunication in the healthcare sector can be life-threatening. The rising number of migrant patients and foreign-trained staff means that communication errors between a healthcare practitioner and patient when one or both are speaking a second language are increasingly likely. However, there is limited research that addresses this issue systematically. This protocol outlines a hospital-based study examining interactions between healthcare practitioners and their patients who either share or do not share a first language. Of particular interest are the nature and efficacy of communication in language-discordant conversations, and the degree to which risk is communicated. Our aim is to understand language barriers and miscommunication that may occur in healthcare settings between patients and healthcare practitioners, especially where at least one of the speakers is using a second (weaker) language. Methods/Design Eighty individual interactions between patients and practitioners who speak either English or Chinese (Mandarin or Cantonese) as their first language will be video recorded in a range of in- and out-patient departments at three hospitals in the Metro South area of Brisbane, Australia. All participants will complete a language background questionnaire. Patients will also complete a short survey rating the effectiveness of the interaction. Recordings will be transcribed and submitted to both quantitative and qualitative analyses to determine elements of the language used that might be particularly problematic and the extent to which language concordance and discordance impacts on the quality of the patient-practitioner consultation. Discussion Understanding the role that language plays in creating barriers to healthcare is critical for healthcare systems that are experiencing an increasing range of culturally and linguistically diverse populations both amongst patients and practitioners. The data resulting from this study will inform policy and practical solutions for communication training, provide an agenda for future research, and extend theory in health communication.

Factors influencing radiation therapy student clinical placement satisfaction

Introduction Radiation therapy students at Queensland University of Technology (QUT) attend clinical placements at five different clinical departments with varying resources and support strategies. This study aimed to determine the relative availability and perceived importance of different factors affecting student support while on clinical placement. The purpose of the research was to inform development of future support mechanisms to enhance radiation therapy students’ experience on clinical placement. Methods This study used anonymous Likert-style surveys to gather data from years 1 and 2 radiation therapy students from QUT and clinical educators from Queensland relating to availability and importance of support mechanisms during clinical placements in a semester. Results The study findings demonstrated student satisfaction with clinical support and suggested that level of support on placement influenced student employment choices. Staff support was perceived as more important than physical resources; particularly access to a named mentor, a clinical educator and weekly formative feedback. Both students and educators highlighted the impact of time pressures. Conclusions The support offered to radiation therapy students by clinical staff is more highly valued than physical resources or models of placement support. Protected time and acknowledgement of the importance of clinical education roles are both invaluable. Joint investment in mentor support by both universities and clinical departments is crucial for facilitation of effective clinical learning.

The new Vancouver Chest Pain Rule using troponin as the only biomarker: An external validation study

Objectives To externally evaluate the accuracy of the new Vancouver Chest Pain Rule and to assess the diagnostic accuracy using either sensitive or highly sensitive troponin assays. Methods Prospectively collected data from 2 emergency departments (EDs) in Australia and New Zealand were analysed. Based on the new Vancouver Chest Pain Rule, low-risk patients were identified using electrocardiogram results, cardiac history, nitrate use, age, pain characteristics and troponin results at 2 hours after presentation. The primary outcome was 30-day diagnosis of acute coronary syndrome (ACS), including acute myocardial infarction, and unstable angina. Sensitivity, specificity, positive predictive values and negative predictive values were calculated to assess the accuracy of the new Vancouver Chest Pain Rule using either sensitive or highly sensitive troponin assay results. Results Of the 1635 patients, 20.4% had an ACS diagnosis at 30 days. Using the highly sensitive troponin assay, 212 (13.0%) patients were eligible for early discharge with 3 patients (1.4%) diagnosed with ACS. Sensitivity was 99.1% (95% CI 97.4-99.7), specificity was 16.1 (95% CI 14.2-18.2), positive predictive values was 23.3 (95% CI 21.1-25.5) and negative predictive values was 98.6 (95% CI 95.9-99.5). The diagnostic accuracy of the rule was similar using the sensitive troponin assay. Conclusions The new Vancouver Chest Pain Rule should be used for the identification of low risk patients presenting to EDs with symptoms of possible ACS, and will reduce the proportion of patients requiring lengthy assessment; however we recommend further outpatient investigation for coronary artery disease in patients identified as low risk.