Information accountability and usability : are there any connections?

Availability of health information is rapidly increasing and the expansion and proliferation of health information is inevitable. The Electronic Healthcare Record, Electronic Medical Record and Personal Health Record are at the core of this trend and are required for appropriate and practicable exchange and sharing of health information. However, it is becoming increasingly recognized that it is essential to preserve patient privacy and information security when utilising sensitive information for clinical, management and administrative processes. Furthermore, the usability of emerging healthcare applications is also becoming a growing concern. This paper proposes a novel approach for integrating consideration of information accountability with a perspective from usability engineering that can be applied when developing healthcare information technology applications. A social networking user case in the healthcare information exchange will be presented in the context of our approach.

Nurse-led trials of medical devices: General principles and good practice

Aim To provide an overview of key governance matters relating to medical device trials and practical advice for nurses wishing to initiate or lead them. Background Medical device trials, which are formal research studies that examine the benefits and risks of therapeutic, non-drug treatment medical devices, have traditionally been the purview of physicians and scientists. The role of nurses in medical device trials historically has been as data collectors or co-ordinators rather than as principal investigators. Nurses more recently play an increasing role in initiating and leading medical device trials. Review Methods A review article of nurse-led trials of medical devices. Discussion Central to the quality and safety of all clinical trials is adherence to the International Conference on Harmonization Guidelines for Good Clinical Practice, which is the internationally-agreed standard for the ethically- and scientifically-sound design, conduct and monitoring of a medical device trial, as well as the analysis, reporting and verification of the data derived from that trial. Key considerations include the class of the medical device, type of medical device trial, regulatory status of the device, implementation of standard operating procedures, obligations of the trial sponsor, indemnity of relevant parties, scrutiny of the trial conduct, trial registration, and reporting and publication of the results. Conclusion Nurse-led trials of medical devices are demanding but rewarding research enterprises. As nursing practice and research increasingly embrace technical interventions, it is vital that nurse researchers contemplating such trials understand and implement the principles of Good Clinical Practice to protect both study participants and the research team.

Australian adolescents’ perceived school-based barriers and facilitators to engagement in physical activity

OBJECTIVE: School-aged youth spend a significant amount of time either in transit to and from school, or within school settings performing a range of varying learning-based activities. Adolescent physical activity has also been shown to increase the likelihood of maintaining physical activity throughout adulthood. The purpose of this study is to investigate adolescents’ perceived school-based barriers and facilitators to engagement in physical activity. METHODS: One-hundred and twenty four participants (38 males and 86 females) were recruited from two non-denominational same-sex private schools, in Brisbane, Australia. The mean age and standard deviation (SD) was 13.83 (0.56) and 14.40 (2.33) for males and females respectively. Participants responded to a series questions regarding perceived barriers and facilitators to engagement in physical activity. Quantitative data was analysed using descriptive statistics and frequency distributions, and qualitative data with thematic analysis. RESULTS: A total of 121 (97.6%) participants had complete data sets and were included in the analysis. School timetable (44.6%), homework (81.8%), and assessment (81.0%) were identified as the most prominent perceived factors, increasing the difficulty of physical activity engagement. Physical Education classes (71.9%) and school sport programs (80.2%) were identified as the most prominent perceived factors that facilitate engagement in physical activity. There was no significant gender effect. CONCLUSIONS: Each of the identified factors perceived by adolescent's as either barriers or facilitators to engagement in physical activity may be addressed by administrators at a school and government policy level. These may include strategies such as; increasing the assigned hours to physical education classes, providing additional extra-curricular sporting opportunities, and reviewing the time allocated to homework and assessment items. This may provide a simpler, low-cost solution to increasing youth physical activity, as opposed to contemporary higher-cost strategies utilising increased staff commitment, mass media, provision of equipment and counsellors and other health professionals.

The use of SMS messaging for physical activity promotion : preferences of Australian adolescents and their parents

OBJECTIVE: Recent increases in youth mobile phone ownership and usage may provide a unique and innovative opportunity for engagement by health promoters, via a familiar and immediately accessible medium. This study investigated adolescents’ and their parents’ preferences for promoting physical activity via means of SMS messaging. METHODS: Adolescents (36 males and 76 females) and their parents (37 males 75 females) were recruited from two non-denominational same-sex private schools, in Brisbane, Australia. The mean age and standard deviation (SD) for adolescents and parents was 14.03 (0.58) and 47.18 (4.65) respectively. Participants responded to a series of questions regarding mobile phone ownership, and preferences for physical activity, school-based physical activity programs, and programs invovling SMS messaging. Data analysis included descriptive statistics and frequency distributions. T-tests were employed to measure gender effect. RESULTS: Overall, 47 (42%) parents desired their child to be more physically active, and were interested for their child to participate in a school-based physical activity program. Of those parents, 16 (34%) parents were interested in their child participating in an SMS-based physical activity program, with 21 (45%) not interested, and 10 (21%) neutral. One hundred and four (95%) adolescents owned a mobile phone, with 84 (82%) of those adolescents wanting to be more physically active. Of those adolescents, 14 (17%) were interested in participating in an SMS-based physical activity program, with 40 (48%) not interested, and 30 (36%) neutral. There was no significant gender effect. CONCLUSIONS: Although SMS messaging may provide an innovative method for youth physical activity promotion, low levels of interest are concerning. These results differ from other studies utilising SMS messaging for the purpose of health promotion, where more positive feedback from participants were reported. A screening process to gauge interest prior to the implementation of any SMS-based health promotion program may prove invaluable toward the success of the program.

Advice to consult a general medical practitioner in Western Australia : Could it be cancer?

Background: Many people will consult a medical practitioner about lower bowel symptoms, and the demand for access to general practitioners (GPs) is growing. We do not know if people recognise the symptoms of lower bowel cancer when advising others about the need to consult a doctor. A structured vignette survey was conducted in Western Australia. Method: Participants were recruited from the waiting rooms at five general practices. Respondents were invited to complete self-administered questionnaires containing nine vignettes chosen at random from a pool of 64 based on six clinical variables. Twenty-seven vignettes described high-risk bowel cancer scenarios. Respondents were asked if they would recommend a medical consultation for the case described and whether they believed the scenario was a cancer presentation. Logistic regression was used to estimate the independent effects of each variable on the respondent's judgement. Two-hundred and sixty-eight completed responses were collected over eight weeks. Results: The majority (61%) of respondents were female, aged 40 years and older. A history of rectal bleeding, six weeks of symptoms, and weight loss independently increased the odds of recommending a consultation with a medical practitioner by a factor of 7.64, 4.11 and 1.86, respectively. Most cases that were identified as cancer (75.2%) would not be classified as such on current research evidence. Factors that predict recognition of cancer presentations include rectal bleeding, weight loss and diarrhoea.

Grunt language versus accent : the perceived communication barriers between international medical graduates and patients in Central Wheatbelt catchments

Due to the chronic shortages of GPs in Australian rural and remote regions, considerable numbers of international medical graduates (IMG) have been recruited. IMG experience many difficulties when relocating to Australia with one of the most significant being effective GP-patient communication. Given that this is essential for effective consultation it can have a substantial impact on health care. A purposive sample of seven practising GPs (five IMG, two Australian-trained doctors (ATD)) was interviewed using a semistructured face-to-face interviewing technique. GPs from Nigeria, Egypt, United Kingdom, India, Singapore and Australia participated. Interviews were transcribed and then coded. The authors used qualitative thematic analysis of interview transcripts to identify common themes. IMG-patient communication barriers were considered significant in the Wheatbelt region as identified by both IMG and ATD. ATD indicated they were aware of IMG-patient communication issues resulting in subsequent consults with patients to explain results and diagnoses. Significantly, a lack of communication between ATD and IMG also emerged, creating a further barrier to effective communication. Analysis of the data generated several important findings that rural GP networks should consider when integrating new IMG into the community. Addressing the challenges related to cross-cultural differences should be a priority, in order to enable effective communication. More open communication between ATD and IMG about GP-patient communication barriers and education programs around GP-patient communication would help both GP and patient satisfaction.

Students' perceptions of teacher biases : experimental economics in schools

We put forward a new experimental economics design with monetary incentives to estimate students’ perceptions of grading discrimination. We use this design in a large field experiment which involved 1,200 British students in grade 8 classrooms across 29 schools. In this design, students are given an endowment they can invest on a task where payoff depends on performance. The task is a written verbal test which is graded non anonymously by their teacher, in a random half of the classrooms, and graded anonymously by an external examiner in the other random half of the classrooms. We find significant evidence that students’ choices reflect perceptions of biases in teachers’ grading practices. Our results show systematic gender interaction effects: male students invest less with female teachers than with male teachers while female students invest more with male teachers than with female teachers. Interestingly, female students’ perceptions are not in line with actual discrimination: Teachers tend to give better grades to students of their own gender. Results do not suggest that ethnicity and socioeconomic status play a role. .

Automatic query expansion : a structural linguistic perspective

A user’s query is considered to be an imprecise description of their information need. Automatic query expansion is the process of reformulating the original query with the goal of improving retrieval effectiveness. Many successful query expansion techniques ignore information about the dependencies that exist between words in natural language. However, more recent approaches have demonstrated that by explicitly modeling associations between terms significant improvements in retrieval effectiveness can be achieved over those that ignore these dependencies. State-of-the-art dependency-based approaches have been shown to primarily model syntagmatic associations. Syntagmatic associations infer a likelihood that two terms co-occur more often than by chance. However, structural linguistics relies on both syntagmatic and paradigmatic associations to deduce the meaning of a word. Given the success of dependency-based approaches and the reliance on word meanings in the query formulation process, we argue that modeling both syntagmatic and paradigmatic information in the query expansion process will improve retrieval effectiveness. This article develops and evaluates a new query expansion technique that is based on a formal, corpus-based model of word meaning that models syntagmatic and paradigmatic associations. We demonstrate that when sufficient statistical information exists, as in the case of longer queries, including paradigmatic information alone provides significant improvements in retrieval effectiveness across a wide variety of data sets. More generally, when our new query expansion approach is applied to large-scale web retrieval it demonstrates significant improvements in retrieval effectiveness over a strong baseline system, based on a commercial search engine.

Schools in New Zealand, doing more with less?

In much the same terms as Australia, New Zealand state schools are funded on a socio-economic status model. The New Zealand model is known as a ‘decile’ system. A decile system is one that “indicates the extent to which the school draws its students from low socio-economic communities” so that students in a Decile 1 school “are the 10% of schools with the highest proportion of students from low socio-economic communities”1. The effect of decile funding is supposed to be that funding to state and state-integrated schools is structured to enable schools to attract funding that meets the specific needs of students from lower socio-economic communities. The lower the school’s decile, the more funding they receive”2. This leads to two interesting questions for the uninitiated into New Zealand education. Firstly, how are deciles calculated? Secondly, what is a state school and how is it different from a state-integrated school?

Term associations in query expansion : a structural linguistic perspective

Many successful query expansion techniques ignore information about the term dependencies that exist within natural language. However, researchers have recently demonstrated that consistent and significant improvements in retrieval effectiveness can be achieved by explicitly modelling term dependencies within the query expansion process. This has created an increased interest in dependency-based models. State-of-the-art dependency-based approaches primarily model term associations known within structural linguistics as syntagmatic associations, which are formed when terms co-occur together more often than by chance. However, structural linguistics proposes that the meaning of a word is also dependent on its paradigmatic associations, which are formed between words that can substitute for each other without effecting the acceptability of a sentence. Given the reliance on word meanings when a user formulates their query, our approach takes the novel step of modelling both syntagmatic and paradigmatic associations within the query expansion process based on the (pseudo) relevant documents returned in web search. The results demonstrate that this approach can provide significant improvements in web re- trieval effectiveness when compared to a strong benchmark retrieval system.

A human rights analysis of a claim for educational negligence in Australian schools

This thesis argues that an action in educational negligence should be available in Australia to provide a remedy for failure by schools and teachers to provide an adequate education as required by Australia’s human rights obligations. The thesis substantiates a duty of care to provide an adequate education under general principles of the law of negligence in appropriate cases. Although some protection exists for disabled students in Australia’s anti-discrimination and other legislation, non-disabled students are not afforded redress under existing causes of action. The educational negligence action provides a suitable remedy in an era of professional educational accountability.

Inclusion, schools and anti-discrimination law : parents' experiences and inclusion

With the increasing enrolment of students with disabilities in primary schools and the enactment of legislative protections for students with disabilities in Disability Discrimination legislation and the Disability Standards for Education, this study examines the experiences of parents of students with disabilities in Queensland State schools. This study is concerned with the experiences that parents of children with disabilities have in relation to the concept and processes of inclusive classroom practice within the primary school. The experiences of parents in large metropolitan schools in Queensland, Australia are analysed in light of current anti-discrimination legislation operating within Australia. Data were collected using a mixed methodology in which 50 parents from nine large metropolitan Queensland State schools responded to a Parent Questionnaire about their experiences in their child’s school. This was followed by two focus groups with a total of six parents who described their experiences in their child’s school. Together the qualitative and quantitative information complemented the other to provide a unique perspective on the impact of anti-discrimination legislation. The findings from the study suggest that parents and their children continue to be discriminated against and that the legislation and associated standards have not eliminated this discrimination. Recommendations are made in the final chapter that propose an inclusive schooling framework for students with disabilities. This intends to ensure not only compliance with the ‘spirit’ of Anti-Discrimination legislation and the Disability Standards, but also a means by which schools may evolve to become inclusive and embracing of difference as part of overall richness of schools as opposed to deficiency.

Averting uncertainty : a practical guide to physical activity research in Australian schools

Preventative health has become central to contemporary health care, identifying youth physical activity as a key factor in determining health and functioning. Schools offer a unique research setting due to distinctive methodological circumstances. However, school-based researchers face several obstacles in their endeavour to complete successful research investigations; often confronted with complex research designs and methodological procedures that are not easily amenable to school contexts. The purpose of this paper is to provide a practical guide for teachers (both teacher educators and teaching practitioners) seeking to conduct physical activity-based research in Australian school settings, as well as discuss research practices. The research enabling process has been divided into six phases: preparation; design; outcome measures; procedures; participants; and feedback. Careful planning and consideration must be undertaken prior to the commencement of, and during the research process, due to the complex nature of school settings and research processes that exist in the Australian context.

The difficulty of establishing causation in medical negligence cases : two recent Australian decisions

This editorial on health and guardianship law provides an overview of the causation issues that precluded the recovery of two medical negligence claims in the cases of Wallace v Kam [2013] HCA 19 and Waller v James [2013] NSWSC 497.