'As many options as there are, there are just not enough for me': Contraceptive use and barriers to access among Australian women

OBJECTIVE A comprehensive life course perspective of women's experiences in obtaining and using contraception in Australia is lacking. This paper explores free-text comments about contraception provided by women born between 1973 and 1978 who participated in the Australian Longitudinal Study on Women's Health (ALSWH). METHODS The ALSWH is a national population-based cohort study involving over 40,000 women from three age groups, who are surveyed every three years. An initial search identified 1600 comments from 690 women across five surveys from 1996 (when they were aged 18-23 years) to 2009 (31-36 years). The analysis included 305 comments from 289 participants. Factors relating to experiences of barriers to access and optimal contraceptive use were identified and explored using thematic analysis. RESULTS Five themes recurred across the five surveys as women aged: (i) side effects affecting physical and mental health; (ii) lack of information about contraception; (iii) negative experiences with health services; (iv) contraceptive failure; and (v) difficulty with accessing contraception. CONCLUSION Side effects of hormonal contraception and concerns about contraceptive failure influence women's mental and physical health. Many barriers to effective contraception persist throughout women's reproductive lives. Further research is needed into reducing barriers and minimising negative experiences, to ensure optimal contraceptive access for Australian women.

Understanding file access mechanisms for embedded ubicomp collaboration interfaces

This paper explores the nature of interfaces to support people in accessing their files at tabletop displays embedded in the environment. To do this, we designed a study comparing people's interaction with two very different classes of file system access interface: Focus, explicitly designed for tabletops, and the familiar hierarchical Windows Explorer. In our within-subjects double-crossover study, participants collaborated on 4 planning tasks. Based on video, logs, questionnaires and interviews, we conclude that both classes of interface have a place. Notably, Focus contributed to improved collaboration and more efficient use of the workspace than with Explorer. Our results inform a set of recommendations for future interfaces enabling this important class of interaction -- supporting access to files for collaboration at tabletop devices embedded in an ubicomp environment.

Delegation of access in an Information Accountability Framework for eHealth

Shared eHealth records systems offer promising benefits for improving healthcare through high availability of information and improved decision making; however, their uptake has been hindered by concerns over the privacy of patient information. To address these privacy concerns while balancing the requirements of healthcare professionals to have access to the information they need to provide appropriate care, the use of an Information Accountability Framework (IAF) has been proposed. For the IAF and so called Accountable-eHealth systems to become a reality, the framework must provide for a diverse range of users and use cases. The initial IAF model did not provide for more diverse use cases including the need for certain users to delegate access to another user in the system to act on their behalf while maintaining accountability. In this paper, we define the requirements for delegation of access in the IAF, how such access policies would be represented in the Framework, and implement and validate an expanded IAF model.

Wikipedia: Access and participation in an open encyclopaedia

This thesis explores how people and technologies work together to coordinate and shape participation through a case study of the online encyclopaedia Wikipedia. The research found participation is shaped by different understandings of openness, where it is constructed as either a libertarian ideal where "anyone" is free to edit the encyclopaedia, or as an inclusive concept that enables "everyone" to participate in the platform. The findings therefore problematise the idea of single user community, and serve to highlight the different and sometimes competing approaches actors employ to enable and constrain participation in Wikipedia.

Measurement of transit network accessibility based on access stop choice behaviour

This research improved the measurement of public transport accessibility by capturing; travellers' behaviour; diversity of public transport mode; and the subjectivity of travellers' decision in the complex transport networks. The results of this research not only highlighted the importance of considering public transport network characteristics but also, revealed the impact of public transport diversity in the modelling of public transport accessibility. The research developed a hybrid discrete choice model with a nested logit structure to treat the correlation among the public transport mode choices and, a logit correction factor to rectify the correlation among the stop choices.

Design-driven digital futures: The role of design-led innovation in the creation of online connected communities for new mobility solutions

Online communities have fundamentally changed how humans connected and are now so common they are fundamental to the human experience. As the Internet developed for Web 1.0 to Web 2.0, the functionality of these communities has far exceeded initial expectations. These communities have shifted from simply places to share information to ways to access products and services that bridge the online and offline worlds. This shift has led to the disruption of many industries with the transportation industry being one such sector. Both private transport providers and public transport systems face competition from online communities who are able to link services providers and customers more effectively and innovatively. These types of communities fall under what has been popularised as collaborative consumption or the sharing economy. The aim of this study is to explore the role of Design-led Innovation in the creation of digital futures, specifically online connected communities for successful new mobility solutions. To explore this proposition multiple data collection methods are proposed;Content Analysis, ii) A Comparative Qualitative Study consisting of Qualitative Interviews and Focus Groups / Design Workshops and iii) An Action Research Cycle of Embedded Practice. The multidisciplinary nature of this study grounds this research in a novel position contributing to new knowledge in both the field of design, and also a deeper understanding of the larger fast-growing online community phenomena.

Can nurses do more for patients to reduce vascular access and cardiac complications following PCI?

Percutaneous coronary interventions have increased 50% in Australia, yet vascular and cardiac complications remain ongoing outcome issues for patients. Managing complications is confounded by reduced length of patient stay, yet is an integral component of a cardiac nurses’ scope of practice. The aim of this study was to highlight in and out of hospital vascular and cardiac complications, for twelve months post patient discharge after PCI. Prospective data was collected from the hospital angioplasty database from 1089 consecutive patients who had PCI procedures from 1 January 2005 to 31 December 2006. In hospital vascular complications were reported by 391 (35%) of the 1089 patients, following PCI. Of these, 22.4% had haemorrhage only, 7.1% haematoma only. Cardiac complications in hospital were, one death (0.09%) following PCI, three deaths (0.27%) during the same admission and no incidence of myocardial infarction or bypass surgery. Patients who had PCI in 2005 (525) were telephone followed up after discharge at one and twelve months. Surprisingly, ongoing vascular outcomes were noted, with a 2.5% incidence at one month and 4% at 12 months. Cardiac complications were also identified, 51 (9.7%) patients requiring readmission for repeat angiogram, 19 (3.6%) a repeat PCI and 7 (1.3%) patients undergoing bypass surgery. This review highlights that vascular and cardiac problems are ongoing issues for PCI patients both in and out of hospital. The results suggest that cardiac nurses focus more on improving the monitoring and discharge care of patients and families for recovery after PCI.

A journey access tool to facilitate better health outcomes for people with disabilities

- Background One of the three objectives of the WHO Global Disability Action Plan 2014–2021 is removal of barriers and improved access to health services and programmes. Access to transport contributes to positive health outcomes; however, people with disabilities leaving their dwellings are confronted with barriers to their mobility. Mobility restrictions, sensory or other disabilities increase their vulnerability as road users, exposing them to higher risks of injury. PHSW and CARRS-Q have been collaborating with Handicap International Cambodia (HIC) on a Journey Access Tool (JAT). - Aims Use of the JAT is to (1) Identify transport and journey safety and barriers for people with disability and (2) Evaluation and modification of the tool after trailing to for use by NGOs and government agencies in prioritising actions around barriers. - Methodology The tool has undergone initial proof-of-concept testing in India and Viet Nam, and was trialled in Cambodia in February and May, 2015. Five teams were formed comprising a person with disability (physical, sensory or intellectual), researchers from QUT, staff from HIC, and local university students. The JAT was completed by each team and then discussed and evaluated. Two further Cambodian trials are scheduled for 2015. - Results The JAT is responsive to rural and urban contexts, and has utility for people with different disabilities. Two tools have been developed: a short version for people with a disability to complete independently, or with assistance; and a version for NGOs, DPOs and government. The tool has efficacy for advocacy.   - Conclusion The JAT has potential to assist the Mekong region with: (1) evaluating access for people with disability and other vulnerable members of the community including older people; (2) developing plans for changes to the routes in consultation with local authorities; (3) evaluating the effectiveness of implemented changes in terms of access and health; (4) inputting into policy; (5) The tool can be used for advocacy for change.

Moments of flux in intermediary liability for copyright infringement

This chapter provides an overview of a recent shift in regulatory strategies to address copyright infringement toward enlisting the assistance of general purpose Internet Service Providers. In Australia, the High Court held in 2012 that iiNet, a general purpose ISP, had no legal duty to police what its subscribers did with their internet connections. We provide an overview of three recent developments in Australian copyright law since that decision that demonstrate an emerging shift in the way that obligations are imposed on ISPs to govern the actions of their users without relying on secondary liability. The first is a new privately negotiated industry code that introduces a 'graduated response' system that requires ISPs to pass on warnings to subscribers who receive allegations of infringement. The second involves a recent series of Federal Court cases where rightsholders made a partially successful application to require ISPs to hand over the identifying details of subscribers whose households are alleged to have infringed copyright. The third is a new legislative scheme that will require ISPs to block access to foreign websites that 'facilitate' infringement. We argue that these shifts represent a greater sophistication in approaches to enrolling general purpose intermediaries in the regulatory project. We also suggest that these shifts represent a potentially disturbing trend towards enforcement of copyright law in a way that does not provide strong safeguards for the legitimate constitutional due process interests of users. We conclude with a call for greater attention and research to better understand how intermediaries make decisions when governing the conduct of users, how those decisions may be influenced by both state and non-state actors, and how the rights of individuals to due process can be adequately protected.

Developing a best practice pathway to support improvements in Indigenous Australians' mental health and well-being: A qualitative study

Objective: There is a need to adapt pathways to care to promote access to mental health services for Indigenous people in Australia. This study explored Indigenous community and service provider perspectives of well-being and ways to promote access to care for Indigenous people at risk of depressive illness. Design: A participatory action research framework was used to inform the development of an agreed early intervention pathway; thematic analysis Setting: 2 remote communities in the Northern Territory. Participants: Using snowball and purposive sampling, 27 service providers and community members with knowledge of the local context and the diverse needs of those at risk of depression were interviewed. 30% of participants were Indigenous. The proposed pathway to care was adapted in response to participant feedback. Results: The study found that Indigenous mental health and well-being is perceived as multifaceted and strongly linked to cultural identity. It also confirms that there is broad support for promotion of a clear pathway to early intervention. Key identified components of this pathway were the health centre, visiting and community-based services, and local community resources including elders, cultural activities and families. Enablers to early intervention were reported. Significant barriers to the detection and treatment of those at risk of depression were identified, including insufficient resources, negative attitudes and stigma, and limited awareness of support options. Conclusions: Successful early intervention for wellbeing concerns requires improved understanding of Indigenous well-being perspectives and a systematic change in service delivery that promotes integration, flexibility and collaboration between services and the community, and recognises the importance of social determinants in health promotion and the healing process. Such changes require policy support, targeted training and education, and ongoing promotion.

Teledermatology: Its use in the detection and management of actinic keratosis

Teledermatology can profoundly improve access to medical services for those who may have limited access to dermatology due to workforce shortages, distance to providers, or limitations in their mobility. Two common ways of teledermatology are differentiated: life synchronous, where patient and doctor communicate directly, or store and forward asynchronous methods, where the patient and doctor provide and assess the medical information independently. Teledermatology has been tested for its safety, feasibility and accuracy for a number of dermatological conditions, including the early detection of skin cancer and is usually safe, feasible and accurate. Studies reported somewhat better results for synchronous than asynchronous methods, possibly because of loss of information if no direct patient doctor contact is feasible. However asynchronous methods are easier to organize, require less sophisticated technology and are more widely accessible, and are more convenient for both patients and doctors. No study to date focused solely on teledermatology of actinic keratosis, but such lesions are typically found during teledermatology examinations for other main target lesions. In studies where such results were reported, actinic keratoses seemed to be readily identifiable for teledermatologists and adequate management and treatment can be suggested within remote consultations.

Safeguard your access to trial by jury

In Watney v Kencian & Wooley [2014] QDC 290 Morxone QC DCJ considered the implications for defendants who desired a trial by jury, but who had relied on the election for that mode of trial made by the plaintiff in the statement of claim.

Pharmacist vaccination – an Australian first, but what was the impact?

Introduction/background/issues The Queensland Pharmacist Immunisation Pilot is Australia’s first to allow pharmacists vaccination. The pilot ran between April 1st 2014 and August 31st 2014, with pharmacists administering influenza vaccination during the flu season. The aim of this work was to investigate the benefits of trained registered pharmacists administering vaccinations in a community pharmacy setting. Methods Participant demographics and previous influenza vaccination experiences were recorded using GuildCare software. Participants also completed a ‘post-vaccination satisfaction survey’ following their influenza vaccination. Results/discussions A total of 10,889 participant records were analysed. Females accounted for 63% of participants, with the majority of participants aged between 45-64 years (53%). Overall, 49% of participants had been vaccinated before, the majority at a GP clinic (60%). Most participants reported receiving their previous influenza vaccination from a nurse (61%). Interestingly, 1% thought a pharmacist had administered their previous vaccination, while 7% were unsure which health professional had administered it. It was also of note that approximately 10% of all participants were eligible to receive a free vaccination from the National Immunisation Program, but still opted to receive their vaccine in a pharmacy. Over 8,000 participants took part in the post-vaccination survey, 93% were happy to receive their vaccination from a pharmacy in the future while 94% would recommend this service to other people. The remaining 7% and 6% respectively had omitted to fill in those questions. Conclusions/implications These findings have helped pave the way for expanding the scope of practice for pharmacists with the aim to increase vaccination rates across Australia. Key message • Scope of practice and ability for health providers like pharmacists to provide services such as vaccination in primary care. • New service delivery to improve access to service, and increase immunisation rates.

Access To Justice In The ASEAN The Key Role Of UNCITRAL

UNCITRAL’s operation as a subsidiary of the UN General Assembly, tasked to unify and harmonise international trade law is a necessary and indispensable element of the UN’s mandate to maintain international peace and security. Strong legal frameworks which are compatible with those of international trading partners often accompany accelerated growth in economic capacity and stability. Over time, access to markets and resultant growth in economic and human development creates a disincentive for instability as incomes and standards of living rise. Human and economic development, facilitated by a modernised and just legal framework that is available to the broadest range of recipients goes hand in hand with the maintenance of domestic and regional peace, particularly in regions such as the ASEAN , one of the fastest growing in the world covering approximately 30% of global population and with a number of strong global economic neighbours including Japan, Korea, China (to the north), Australia (to the south) and Singapore (to the west). In an increasingly interconnected world, the ability of government, enterprise and individuals to participate in the global supply chain offers opportunities for economic growth and development. Over its almost 50 years of operations, UNCITRAL has produced a range of important texts that are designed to underpin world trade. A key implicit assumption underpinning the development of UNCITRAL texts is that the texts, once adopted can and will be applied in adopting states.

Digital access to knowledge in the preschool classroom: Reports from Australia

Australian preschool teachers’ use of Web-searching in their classroom practice was examined (N = 131). Availability of Internet-enabled digital technology and the contribution of teacher demographic characteristics, comfort with digital technologies and beliefs about their use were assessed. Internet-enabled technologies were available in 53% (n = 69) of classrooms. Within these classrooms, teacher age and beliefs predicted Web-searching practice. Although comfortable with digital access of knowledge in their everyday life, teachers reported less comfort with Web-searching in the context of their classroom practice. The findings identify the provision of Internet-enabled technologies and professional development as actions to support effective and confident inclusion of Web-searching in classrooms. Such actions are necessary to align with national policy documents that define acquisition of digital literacies as a goal and assert digital access to knowledge as an issue of equity.