"It broke our hearts": Understanding parents' lived experiences of their child's admission to an acute mental health care facility

This article reports the evaluative findings of an Early Psychosis Education Program (EPEP) designed to support parents caring for their child who was recently admitted to the psychiatric intensive care unit of an inpatient mental health care facility in Australia. The EPEP offered education on mental illness, treatment options, and medication, as well as information on the recovery model of care. The EPEP was facilitated by two RNs and was evaluated for educational effectiveness using a simple pre- and postevaluation questionnaire. The evaluation revealed two themes expressed by parents: "We didn't see it coming," and "Hopelessness and helplessness." The themes highlighted the parents' lack of mental health care knowledge prior to the EPEP, which had a significant impact on the parents' experiences and well-being. The evaluative findings highlighted a need for a nurse-led EPEP within the community. A community EPEP has the potential to strengthen the partnership between parents, families, and mental health service providers and to help with the provision of a recovery framework of care.

Strenthening information literacy through collaboration: Implications for AIM

Because of its size, its excellent VET history, and its emerging higher education provision, AIM is in a special position to be an exemplar of good practice in the VET-HE transition. Many dual sector providers, by virtue of their size, tend to focus on higher education, on the assumption that VET ‘competence’ implies that their VET entrants to HE are confident and capable in information literacy skills. While this is only one of the many challenges that such students face in their undergraduate programs, it is the most critical for most of them in their quest for academic success. All students (school leavers, gap-year participants, articulating, mature age) entering HE will face specific challenges. For articulating students, the nature of credit transfer arrangements will often mean they commence studies in units that are not designated first year units. In this case, the embedded support structures are not as prominent. The existing literature is not consistent in reports on the rates of completion, retention and attrition of articulating students. There is some evidence that VET-qualified students have higher retention rates than school leavers [1], but limited information literacy skills can lead to attrition [2].

Solo holiday travellers: Motivators and drivers of satisfaction and dissatisfaction

A growing number of people are travelling alone for holidays, yet limited research addresses this topic. This paper explores the main motivators and drivers of satisfaction and dissatisfaction for solo holiday travellers using a critical incident technique (CIT) to collect and analyse data. The findings show that drivers of satisfaction for solo holiday travellers are more related to personal feelings of freedom, relaxation and discovery (personal factors), and interaction with other people (human interaction factors), than with holiday destination factors. Safety (a destination factor) and unfriendly service providers (a human interaction factor) are the main sources of dissatisfaction for solo holiday travellers.

Women's perceptions of communication in pregnancy and childbirth: Influences on participation and satisfaction with care

In this study, 3531 Queensland women, who had recently given birth, completed a questionnaire that included questions about their participation in decision making during pregnancy, their ratings of client centred care and perceived quality of care. These data tested a version of Street’s (2001) linguistic model of patient participation in care (LMOPPC), adapted to the maternity context. We investigated how age and education influenced women’s perceptions of their participation and quality of care. Hierarchical multiple regressions revealed that women’s perceived ability to make decisions, and the extent of client-centred communication with maternity care providers were the most influential predictors of participation and perceived quality of care. Participation in care predicted perceived quality of care, but the influence of client-centred communication by a care provider and a woman’s confidence in decision making were stronger predictors of perceived quality of care. Age and education level were not important predictors. These findings extend and support the use of LMOPPC in the maternity context.

Submission to KPMG review of the Federal Government Initiative to “analyse dementia program and services funded by the Department of Social Services"

The comments I make are based on my nearly twenty years involvement in the dementia cause at both a national and international level. In preparation, I read two papers namely the Ministerial Dementia Forum – Option Paper produced by KPMG Management Consultants (2014) and Analysis of Dementia Programmes and Services Funded by the Department of Social Services: Conversation Starter prepared by KPMG as a preparation document for those attending a workshop in Brisbane on April 22nd 2015. Dementia is a complex “syndrome” and as is often said, “when you meet one person with dementia, you have met one” meaning that no two persons with dementia are the same. Even in dementia care, Australia is a “lucky country” and there is much to be said for the quality and diversity of dementia care available for people living with dementia. Despite this, I agree with the many views expressed in the material I read that there is scope for improvement, especially in the way that services are coordinated. In saying that, I do not purport to have all the solutions nor claim to have the knowledge required to comment on all the programs covered by this review. If I appear to be a “biased” advocate for Alzheimer’s Australia across the States and Territories, it is because I have seen constant evidence of ordinary people doing extraordinary things with inadequate resources. Dementia care is not cheap and if those funding dementia services are primarily only interested in economic outcomes and benefits, the real purpose of this consultation will be defeated. In addition, nowhere in the material I have read is there any recognition that in many instances program funding is a complex mix of government (at all levels) and private funding. This makes reviewing those programs more complex and less able to be coordinated at a Departmental level. It goes without saying therefore that the Federal Government is not” the only player in this game”. Of all those participating in this review, Alzheimer’s Australia is best placed to comment on programs as it is more connected to people living with dementia and has probably the best record of consulting with them. It would appear however that their role has been reduced to that of a “bit player”. Without wanting to be critical, the Forum Report which deals with the comments made at a gathering of 70 individuals and organisations, only three (3) or 4.28% were actual carers of people living with dementia. Even if it is argued that a number of organisations present represented consumers, the percentage goes up only marginally to 8.57% which is hardly an endorsement of the forum being “consumer driven”. The predominance of those present were service providers, each with their own agenda and each seeking advantage for their “business”. The final point I want to make before commenting on more specific, program related issues, is that many programs being reviewed have a much longer history than is reflected in the material I have read. Their growth and development was pioneered by Alzheimer’s Australia organisations across the country often with no government funding. Attempts to bring about better coordination of programs were often at the behest of Alzheimer’s Australia but in the main were ignored. The opportunity to now put this right is long overdue.

Medically-attended respiratory illnesses amongst pregnant women in Brisbane, Australia

There are limited community-based data on the burden of influenza and influenza-like illnesses during pregnancy to inform disease surveillance and control. We aimed to determine the incidence of medically-attended respiratory illnesses (MARI) in pregnant women and the proportion of women who are tested for respiratory pathogens at these visits. We conducted a nested retrospective cohort study of a non-random sample of women aged ≥18 years who had a live birth in maternity units in Brisbane, Queensland, from March 2012 to October 2014. The primary outcomes were self-reported doctor visits for MARI and laboratory investigations for respiratory pathogens. Descriptive analyses were performed. Among 1202 participants, 222 (18.5%, 95%CI 16.3%-20.7%) self-reported MARI during their pregnancy. Of those with an MARI, 20.3% (45/222) self-reported a laboratory test was performed. We were able to confirm with health service providers that 46.7% (21/45) of tests were undertaken, responses from providers were not received for the remainder. Whilst one in five women in this population reported a MARI in pregnancy, only 3.7% (45/1202) reported a clinical specimen had been arranged at the consultation and the ability to validate that self-report was problematic. As the focus on maternal immunisation increases, ascertainment of the aetiological agent causing MARI in this population will be required and efficient and reliable methods for obtaining those data at the community level need to be established.

The responsibility of intermediaries: Emerging IP protection schemes, from Content ID, to three-strikes and follow-the-money

The only effective and scalable way to regulate the actions of people on the internet is through online intermediaries. These are the institutions that facilitate communication: internet service providers, search engines, content hosts, and social networks. Governments, private firms, and civil society organisations are increasingly seeking to influence these intermediaries to take more responsibility to prevent or respond to IP infringements. Around the world, intermediaries are increasingly subject to a variety of obligations to help enforce IP rights, ranging from informal social and governmental pressure, to industry codes and private negotiated agreements, to formal legislative schemes. This paper provides an overview of this emerging shift in regulatory approaches, away from legal liability and towards increased responsibilities for intermediaries. This shift straddles two different potential futures: an optimistic set of more effective, more efficient mechanisms for regulating user behaviour, and a dystopian vision of rule by algorithm and private power, without the legitimising influence of the rule of law.

Claiming the moral high ground in the copyright wars

Copyright was once one of the more obscure areas of law. It applied primarily to resolve disputes between rival publishers, and there was a time, not too long ago, when ordinary people gave it no thought. Copyright disputes were like subatomic particles: everyone knew that they existed, but nobody had ever seen one. In the digital age, however, copyright has become a heated, passionate, bloody battleground. The 'copyright wars' now pitch readers against authors, pirates against publishers, and content owners against communications providers. Everyone has heard a movie producer decry the rampant infringement of streaming sites, or a music executive suggest that BitTorrent is the end of civilisation as we know it. But everyone infringes copyright on an almost constant basis - streaming amateur videos with a soundtrack that isn't quite licensed, filesharing mp3s, copying LOLcat pictures from Facebook, posting pictures on Pinterest without permission, and so on - and most know full well they're in breach of the law.

Advance care planning in stroke: Influence of time on engagement in the process

Purpose Individuals who experience stroke have a higher likelihood of subsequent stroke events, making it imperative to plan for future medical care. In the event of a further serious health event, engaging in the process of advanced care planning (ACP) can help family members and health care professionals (HCPs) make medical decisions for individuals who have lost the capacity to do so. Few studies have explored the views and experiences of patients with stroke about discussing their wishes and preferences for future medical events, and the extent to which stroke HCPs engage in conversations around planning for such events. In this study, we sought to understand how the process of ACP unfolded between HCPs and patients post-stroke. Patients and methods Using grounded theory (GT) methodology, we engaged in direct observation of HCP and patient interactions on an acute stroke unit and two stroke rehabilitation units. Using semi-structured interviews, 14 patients and four HCPs were interviewed directly about the ACP process. Results We found that open and continual ACP conversations were not taking place, patients experienced an apparent lack of urgency to engage in ACP, and HCPs were uncomfortable initiating ACP conversations due to the sensitive nature of the topic. Conclusion In this study, we identified lack of engagement in ACP post-stroke, attributable to patient and HCP factors. This encourages us to look further into the process of ACP in order to develop open communication between the patient with stroke, their families, and stroke HCPs.

Practice uncertainty: Changing perceptions

Practice uncertainty occurs when health care providers feel uncomfortable in response to unfamiliar or challenging patient care situations. Practice uncertainty is inevitable in health care, and there are many contextual factors that can lead to either good or bad outcomes for patients and health care providers. Practice uncertainty is not a well-established concept in the literature, perhaps because of the predominant empirical paradigm and the high value placed on certainty within current health care culture. This study was conducted to explore practice uncertainty and bring this topic into the foreground as a first step toward practice evolution. A shift in the perception of practice uncertainty may change the way in which practitioners experience this phenomenon. This process must start with nursing educators recognizing and acknowledging this phenomenon when it occurs.

Students’ well-being and social connections

Description of Workshop/Poster Presentation This presentation will showcase CORE Connections – ‘Creating Opportunities for Resilience and Engagement’ – which is a whole-school approach to mental health promotion. While initially designed to prevent adolescent depression and substance abuse, current thinking suggests that competency enhancement (e.g., autonomy, competence, supportive networks) more widely improves students’ well-being, educational engagement, and learning outcomes. In the presentation, we will provide an overview of the CORE project, describe the CORE intervention, which is conceptualized as a dynamic and penetrating process of social practices, present some preliminary findings from the pilot phase of CORE, and conclude our presentation with an interactive section with the participants. This project will highlight a wellness focus that addresses social engagement within whole school cultures. Purpose of the Presentation Student mental and physical well-being has gained increasing attention. Our presentation will introduce the CORE project, which has a potential to decrease student depression, anxiety, and substance use, and to increase student self-esteem and learning outcomes. In this vein, our presentation will raise the public awareness of the salient role of social connection in student well-being. Specifically, a group of presenters will discuss the impact of social connection on students’ anxiety, mathematics achievement, and perceived racial discrimination. • We will present participants with an alternative way to conceptualize and approach mental health promotion within a school context. In contrast to prescribed programs that are commonly used in today’s schools, CORE is a whole-school approach that is flexibly integrated into all aspects of the classroom and school environment. Our aim is to illustrate the intervention principles of CORE while highlighting examples of mental health outcomes/transformation. • Underutilized in mental health promotion research, social network analysis provides critical information in understanding relationships between social cohesion (e.g., a student’s connectedness to others) and mental health outcomes. This session will showcase how focusing on and strengthening social connections in and out of school can contribute to student well-being, achievement, and mental health. Educational Objectives By the end of the presentation, participants will • obtain a general overview of the CORE program, • understand how psychological health and school performance relate to student well-being, • and understand how social connections in and out of school can contribute to student well-being. Interactive / Participatory Component We will invite audience members to discuss inhibitors and contributors to student well-being and the best ways for schools to help students feel safe, connected, and valued. Presentation Key Points • Overview of the CORE project • Theorization of social connection • Some empirical studies emerging from CORE • Presenter-audience interaction Evidence of Relevance and Utility to Participants Potential participants are adults with significant relationships with students, either as family members, community neighbors, educators, scholars, service providers, or policy makers. Our presentation will inspire these significant adults to construct a welcoming society to help improve student well-being.

Facebook and Google have a moral duty to stop online abuse

It’s the stuff of nightmares: your intimate images are leaked and posted online by somebody you thought you could trust. But in Australia, victims often have no real legal remedy for this kind of abuse. This is the key problem of regulating the internet. Often, speech we might consider abusive or offensive isn’t actually illegal. And even when the law technically prohibits something, enforcing it directly against offenders can be difficult. It is a slow and expensive process, and where the offender or the content is overseas, there is virtually nothing victims can do. Ultimately, punishing intermediaries for content posted by third parties isn’t helpful. But we do need to have a meaningful conversation about how we want our shared online spaces to feel. The providers of these spaces have a moral, if not legal, obligation to facilitate this conversation.

Aaron's army fights the Trans-Pacific Partnership

In light of the death of internet activist Aaron Swartz, there is a need to reconsider intellectual property enforcement standards in the Trans-Pacific Partnership. The 16th round of the Trans-Pacific Partnership negotiations are taking place in Singapore until March 13. There have been concerns that the Intellectual Property Chapter would “ratchet up IP enforcement at the expense of digital rights”. Maira Sutton of the Electronic Frontier Foundation fears that “the Trans-Pacific Partnership could turn Internet Service Providers into copyright cops, prompt ever-higher criminal and civil penalties for sharing content, and expand protections for Digital Rights Management”. The case of Aaron Swartz highlights the need for a reconsideration of punitive and excessive intellectual property enforcement provisions in trade agreements.

Breakfast at Tiffany's': eBay Inc., trade mark law, and counterfeiting

In an exploration of intellectual property and fashion, this article examines the question of the intermediary liability of online auction-houses for counterfeiting. In the United States, the illustrious jewellery store, Tiffany & Co, brought a legal action against eBay Inc, alleging direct trademark infringement, contributory trademark infringement, false advertising, unfair competition and trademark dilution. The luxury store depicted the online auction-house as a pirate bazaar, a flea-market and a haven for counterfeiting. During epic litigation, eBay Inc successfully defended itself against these allegations in a United States District Court and the United States Court of Appeals for the Second Circuit. Tiffany & Co made a desperate, unsuccessful effort to appeal the matter to the Supreme Court of the United States. The matter featured a number of interventions from amicus curiae — Tiffany was supported by Coty, the Fashion Designer's Guild, and the International Anticounterfeiting Coalition, while eBay was defended by publicly-spirited civil society groups such as Electronic Frontier Foundation, Public Citizen, and Public Knowledge as well as Yahoo!, Google Inc, Amazon.com, and associations representing telecommunications carriers and internet service providers. The litigation in the United States can be counterpointed with the fusillade of legal action against eBay in the European Union. In contrast to Tiffany & Co, Louis Vuitton triumphed over eBay in the French courts — claiming its victory as vindication of the need to protect the commercial interests and cultural heritage of France. However, eBay has fared somewhat better in a dispute with L’Oréal in Great Britain and the European Court of Justice. It is argued that, in a time of flux and uncertainty, Australia should follow the position of the United States courts in Tiffany & Co v eBay Inc. The final part examines the ramifications of this litigation over online auction-houses for trade mark law reform and consumer rights; parallel disputes over intermediary liability and safe harbours in the field of copyright law and the Anti-Counterfeiting Trade Agreement 2010. The conclusion calls for a revision of trade mark law, animated by a respect for consumers’ rights and interests in the electronic marketplace.

Canadian rhapsody: Copyright law and research libraries

This article considers the ground-breaking Supreme Court of Canada decision in The Law Society of Upper Canada v CCH Canadian Limited. The matter involved legal publishers bringing an action for copyright infringement against the Law Society of Upper Canada for operating a photocopy and custom copy service at the Great Library of Osgoode Hall. The Supreme Court of Canada decision laid down important precedents in relation to originality, authorisation, and the defence of fair dealing. The ruling has been hailed as ’one of the strongest pro-user rights decisions from any high court in the world, showing what it means to do more than pay mere lip service to balance in copyright'. This decision will have important implications for the regulation of new technologies. The approach has been applied in two decisions dealing copyright law and the Internet - the Canadian Federal Court case of BMG Canada v John Doe, and the Supreme Court of Canada ’Tariff 22' case. The Supreme Court of Canada decision in The Law Society of Upper Canada v CCH Canadian Limited provides an impetus to reconsider the judicial interpretation of user rights in Australian jurisprudence.