An exploratory study of staff nurses' knowledge of delirium in the medical ICU: An Asian perspective

Aim The aim of this study was to establish intensive care unit nurses’ knowledge of delirium within an acute tertiary hospital within South East Asia. Background Delirium is a common, life threatening and often preventable cause of morbidity and mortality among older patients. Undetected and untreated delirium is a catalyst to increased mortality, morbidity, functional decline and results in increased requirement for nursing care, healthcare expense and hospital length of stay. However, despite effective assessment tools to identify delirium in the acute setting, there still remains an inability of ICU nurses’ to accurately identify delirium in the critically ill patient especially that of hypoactive delirium. Method A purposive sample of 53 staff nurses from a 13-bedded medical intensive care unit within an acute tertiary teaching hospital in South East Asia were asked to participate. A 40 item 5-point Likert scale questionnaire was employed to determine the participants’ knowledge of the signs and symptoms; the risk factors and negative outcomes of delirium. Results The overall positively answered mean score was 27 (67.3%) out of a possible 40 questions. Mean scores for knowledge of signs and symptoms, risk factors and negative outcomes were 9.52 (63.5%, n = 15), 11.43 (63.5%, n = 17) and 6.0 (75%, n = 8), respectively. Conclusion Whilst the results of this study are similar to others taken from a western perspective, it appeared that the ICU nurses in this study demonstrated limited knowledge of the signs and symptoms, risk factors and negative outcomes of delirium in the critically patient. The implications for practice of this are important given the outcomes of untreated delirium.

Recontextualising policy discourses : a Bernsteinian perspective on policy interpretation, translation, enactment

This paper contributes to critical policy research by theorising one aspect of policy enactment, the meaning making work of a cohort of mid-level policy actors. Specifically, we propose that Basil Bernstein’s work on the structuring of pedagogic discourse, in particular, the concept of recontextualisation, may add to understandings of the policy work of interpretation and translation. Recontextualisation refers to the relational processes of selecting and moving knowledge from one context to another, as well as to the distinctive re-organisation of knowledge as an instructional and regulative or moral discourse. Processes of recontextualisation necessitate an analysis of power and control relations, and therefore add to the Foucauldian theorisations of power that currently dominate the critical policy literature. A process of code elaboration (decoding and recoding) takes place in various recontextualising agencies, responsible for the production of professional development materials, teaching guidelines and curriculum resources. We propose that mid-level policy actors are crucial to the work of policy interpretation and translation because they are engaged in elaborating the condensed codes of policy texts to an imagined logic of teachers’ practical work. To illustrate our theoretical points we draw on data; collected for an Australian research project on the accounts of mid-level policy actors responsible for the interpretation of child protection and safety policies for staff in Queensland schools.

Public sector project delay : the Malaysian perspective and the way forward

Construction delay has been a protracted problem for the Malaysian construction industry. Recent report showed that 80% of public sector projects are behind schedule. This underachieving time performance has led to many problems including public complaints, loss of reputation and revenue for the government and a slump in the industry’s GDP contribution. Research in the area of project delay has mushroomed worldwide with attempts to place mitigation plans, but delay remains a global phenomenon. There is now an urgent need for revolutionizing construction practices and past research, backed up with few successful cases suggests that Supply Chain Management (SCM) could prove beneficial to reduce or eliminate delays in construction. SCM which originated from the automotive manufacturing industry promotes a more collaborative approach to construction management and has recently gained attention of the construction industry. However every country, including Malaysia, would certainly have disparities of their own compared to others being it from the cultural point of view, nature of problems, locality or improvements needed. Therefore, this paper will present part of a Ph.D. research which aims at illustrating the Malaysian construction industry experts’ perception of the Malaysian public sector project delay, provide insight into these dilemmas, highlights the problems with current practices, its effects and the improvements needed. Subsequently, this paper would propose ratification to the problems using SCM. A semi-structured interview has been conducted to practitioners with at least 20 years’ experience in the industry. The findings showed that Malaysia may be unique compared to other countries and that by considering a number of additional factors, SCM could prove beneficial to increase efficiency of the Malaysian public sector projects.

Automatic de-identification of electronic health records : an Australian perspective

We present an approach to automatically de-identify health records. In our approach, personal health information is identified using a Conditional Random Fields machine learning classifier, a large set of linguistic and lexical features, and pattern matching techniques. Identified personal information is then removed from the reports. The de-identification of personal health information is fundamental for the sharing and secondary use of electronic health records, for example for data mining and disease monitoring. The effectiveness of our approach is first evaluated on the 2007 i2b2 Shared Task dataset, a widely adopted dataset for evaluating de-identification techniques. Subsequently, we investigate the robustness of the approach to limited training data; we study its effectiveness on different type and quality of data by evaluating the approach on scanned pathology reports from an Australian institution. This data contains optical character recognition errors, as well as linguistic conventions that differ from those contained in the i2b2 dataset, for example different date formats. The findings suggest that our approach compares to the best approach from the 2007 i2b2 Shared Task; in addition, the approach is found to be robust to variations of training size, data type and quality in presence of sufficient training data.

Wetlands : a perspective for mapping, monitoring, and modeling

Experience gained from numerous projects conducted by the U.S. Environmental Protection Agency's (EPA) Environmental Monitoring Systems Laboratory in Las Vegas, Nevada has provided insight to functional issues of mapping, monitoring, and modeling of wetland habitats. Three case studies in poster form describe these issues pertinent to managing wetland resources as mandated under Federal laws. A multiphase project was initiated by the EPA Alaska operations office to provide detailed wetland mapping of arctic plant communities in an area under petroleum development pressure. Existing classification systems did not meet EPA needs. Therefore a Habitat Classification System (HCS) derived from aerial photography was compiled. In conjunction with this photointerpretive keys were developed. These products enable EPA personnel to map large inaccessible areas of the arctic coastal plain and evaluate the sensitivity of various wetland habitats relative to petroleum development needs.

Perceptions of online learning in an Australian university: an international students’ (Asian Region) perspective – enjoyment

Several researchers have reported that cultural and language differences can affect online interactions and communications between students from different cultural backgrounds. Other researchers have asserted that online learning is a tool that can improve teaching and learning skills, but its effectiveness depends on how the tool is used. To delve into these aspects further, this study set out to investigate the kinds of learning difficulties encountered by the international students and how they actually coped with online learning. The modified Online Learning Environment Survey (OLES) instrument was used to collect data from the sample of 109 international students at a university in Brisbane. A smaller group of 35 domestic students was also included for comparison purposes. Contrary to assumptions from previous research, the findings revealed that there were only few differences between the international Asian and Australian students with regards to their perceptions of online learning. Recommendations based on the findings of this research study were made for Australian universities where Asian international students study online. Specifically the recommendations highlighted the importance of upskilling of lecturers’ ability to structure their teaching online and to apply strong theoretical underpinnings when designing learning activities such as discussion forums, and for the university to establish a degree of consistency with regards to how content is located and displayed in a learning management system like Blackboard.

Safety management in repair, maintenance, minor alteration, and addition works : knowledge management perspective

Safety of repair, maintenance, alteration, and addition (RMAA) works have long been neglected because RMAAworks are often minute and only last for a short period of time. With rising importance of the RMAA sector in many developed societies, safety of RMAA works has begun to draw attention. Many RMAA contracting companies are small- and medium-sized enterprises (SMEs) that do not have comprehensive safety management systems. Existing safety legislation and regulations for new construction sites are not fully applicable to RMAAworks. Instead of relying on explicit and well-established safety systems, tacit safety knowledge plays an extremely important role in RMAA projects. To improve safety of RMAAworks, safety knowledge should be better managed. However, safety knowledge is difficult to capture in RMAA works. This study aims to examine safety management practices of RMAA contracting companies to see how safety knowledge of RMAA projects is managed. Findings show that RMAA contracting companies undertaking large-scale RMAA projects have more initiatives of safety management. Safety management of small-scale RMAA works relies heavily on the motivation of site supervisors and self-regulation of workers. Better tacit knowledge management improves safety performance. To enhance safety capability of RMAA contracting companies, a knowledge sharing culture should be cultivated. The government should provide assistance to SMEs to implement proper safety management practices in small-sized projects. Potentials of applying computer software technology in RMAA projects to capture, store, and retrieve safety information should be explored. Employees should be motivated to share safety knowledge by giving proper recognition to those who are willing to share.

More than simple living : a cultural perspective on sustainable living

This paper provides a cultural perspective to the sustainability research within HCI. I draw on the results from an ethnographic field study of sustainable household practices of ten women belonging to the so-called middle class in India. Focusing on their reuse practices, I provide examples of domestic artefacts that are creatively and resourcefully reused from worn-out artefacts. My initial findings show that the rationale behind creating such artefacts is not limited to the practicality and usefulness, but how cultural and religious beliefs are incorporated into such practices.

Designing for Awareness: An Experience-focused HCI Perspective

Within Human-Computer Interaction (HCI) and Computer Supported Cooperative Work (CSCW) research, the notion of technologically-mediated awareness is often used for allowing relevant people to maintain a mental model of activities, behaviors and status information about each other so that they can organize and coordinate work or other joint activities. The initial conceptions of awareness focused largely on improving productivity and efficiency within work environments. With new social, cultural and commercial needs and the emergence of novel computing technologies, the focus of technologically-mediated awareness has extended from work environments to people’s everyday interactions. Hence, the scope of awareness has extended from conveying work related activities to people’s emotions, love, social status and other broad range of aspects. This trend of conceptualizing HCI design is termed as experience-focused HCI. In my PhD dissertation, designing for awareness, I have reported on how we, as HCI researchers, can design awareness systems from experience-focused HCI perspective that follow the trend of conveying awareness beyond the task-based, instrumental and productive needs. Within the overall aim to design for awareness, my research advocates ethnomethodologically-informed approaches for conceptualizing and designing for awareness. In this sense, awareness is not a predefined phenomenon but something that is situated and particular to a given environment. I have used this approach in two design cases of developing interactive systems that support awareness beyond task-based aspects in work environments. In both the cases, I have followed a complete design cycle: collecting an in-situ understanding of an environment, developing implications for a new technology, implementing a prototype technology to studying the use of the technology in its natural settings.

Bone regeneration based on tissue engineering conceptions – a 21st century perspective

The role of Bone Tissue Engineering in the field of Regenerative Medicine has been the topic of substantial research over the past two decades. Technological advances have improved orthopaedic implants and surgical techniques for bone reconstruction. However, improvements in surgical techniques to reconstruct bone have been limited by the paucity of autologous materials available and donor site morbidity. Recent advances in the development of biomaterials have provided attractive alternatives to bone grafting expanding the surgical options for restoring the form and function of injured bone. Specifically, novel bioactive (second generation) biomaterials have been developed that are characterised by controlled action and reaction to the host tissue environment, whilst exhibiting controlled chemical breakdown and resorption with an ultimate replacement by regenerating tissue. Future generations of biomaterials (third generation) are designed to be not only osteo- conductive but also osteoinductive, i.e. to stimulate regeneration of host tissues by combining tissue engineer- ing and in situ tissue regeneration methods with a focus on novel applications. These techniques will lead to novel possibilities for tissue regeneration and repair. At present, tissue engineered constructs that may find future use as bone grafts for complex skeletal defects, whether from post-traumatic, degenerative, neoplastic or congenital/developmental “origin” require osseous reconstruction to ensure structural and functional integrity. Engineering functional bone using combinations of cells, scaffolds and bioactive factors is a promising strategy and a particular feature for future development in the area of hybrid materials which are able to exhibit suitable biomimetic and mechanical properties. This review will discuss the state of the art in this field and what we can expect from future generations of bone regeneration concepts.

Gender inequities in health research : an Australian perspective

This chapter presents the current challenges facing legislators, regulators, researchers, and ethics committees in determining how and when to include women appropriately in research, and ensure that sex analysis of research results is routinely performed. It offers five issues that require attention to address these challenges: that national regulatory statements could provide researchers with definitions of the terms ‘sex’ , ‘gender’, and ‘gender equity’ in research; that sex and gender analysis should be built into health research protocols; the lack of internationally comparable data regarding the rates of inclusion of men and women presents a major hurdle for analysing the efficacy of different regulatory strategies; the accessibility of data would be facilitated by a requirement for publication of the results of health research to include descriptions of sex analysis performed on research data; and that institutional review boards, research ethics committees, and researchers themselves require better education about the scientific and ethical importance of including of women in clinical research.

Optimising employee engagement with internal communication : a social exchange perspective

Drawing on principles of social exchange this thesis employs mediated regression to investigate the relationship between internal communication and employee engagement in the Australian workforce. Findings suggest organisations and supervisors should focus internal communication efforts toward building greater perceptions of support and stronger identification among employees in order to foster optimal engagement. This research contributes to public relations and management scholarship through understanding how perceived support and identification act as mediating mechanisms in the relationship between internal communication and employee engagement at the organisational and supervisory level.

Designing intelligent litigation support tools : The IKBALS perspective

In the legal domain, it is rare to find solutions to problems by simply applying algorithms or invoking deductive rules in some knowledge‐based program. Instead, expert practitioners often supplement domain‐specific knowledge with field experience. This type of expertise is often applied in the form of an analogy. This research proposes to combine both reasoning with precedents and reasoning with statutes and regulations in a way that will enhance the statutory interpretation task. This is being attempted through the integration of database and expert system technologies. Case‐based reasoning is being used to model legal precedents while rule‐based reasoning modules are being used to model the legislation and other types of causal knowledge. It is hoped to generalise these findings and to develop a formal methodology for integrating case‐based databases with rule‐based expert systems in the legal domain.

What is a good project manager? An Aristotelian perspective

The purpose of this paper is to take a critical look at the question “what is a competent project manager?” and bring some fresh added-value insights. This leads us to analyze the definitions, and assessment approaches of project manager competence. Three major standards as prescribed by PMI, IPMA, and GAPPS are considered for review from an attribute-based and performance-based approach and from a deontological and consequentialist ethics perspectives. Two fundamental tensions are identified: an ethical tension between the standards and the related competence assessment frameworks and a tension between attribute and performance-based approaches. Aristotelian ethical and practical philosophy is brought in to reconcile these differences. Considering ethics of character that rises beyond the normative deontological and consequentialist perspectives is suggested. Taking the mediating role of praxis and phrónêsis between theory and practice into consideration is advocated to resolve the tension between performance and attribute-based approaches to competence assessment.

Learning and development opportunities as a tool for the retention of volunteers : a motivation perspective

The growing reliance on volunteers in Australia has heightened the need for non-profit organisations to retain these valuable resources. However, the current literature on volunteer retention is limited. One potential way volunteers can be retained is by providing learning and development opportunities (LDOs). This study investigates the relationship between volunteer perceptions of LDOs, their motivations for volunteering, and retention. Analyses revealed significant main effects for LDOs and volunteer motivations on retention and several interactive effects demonstrating that LDOs can have differential effects on retention depending on the reasons for volunteering.