Triaging older major trauma patients in the emergency department: An observational study

Background The objective of this study was to compare the triage category assigned to older trauma patients with younger trauma patients upon arrival to the emergency department. The focus was to examine whether older major trauma patients were less likely to be assigned an emergency triage category on arrival to the emergency department after controlling for relevant demographics, injury characteristics and injury severity. Methods This was an observational study using data from the Queensland Trauma Registry. All trauma patients aged 15 years and older who presented to contributing hospitals between 1 January 2005 and 31 December 2009 with an Injury Severity Score (ISS)>15 were included. Logistic regression analysis examined the odds of assignment to emergency (Australasian Triage Scale (ATS) 1 or 2) versus urgent (ATS 3–5) treatment for patients across various age categories after adjustment for relevant demographics, injury characteristics and injury severity. Results The study used data on 6923 patients with a median (IQR) age of 43 (26–62) years and a mortality of 11.4% (95% CI 10.7% to 12.2%). Compared with individuals aged 15–34, the adjusted odds of being assigned an ATS category 1 or 2 were 30% lower (OR=0.68, 95% CI 0.57 to 0.81) for individuals aged 55–75 years and were 50% lower (OR=0.46, 95% CI 0.37 to 0.56) for individuals aged 75 years or older. Conclusions Among patients with an ISS>15, older major trauma patients were less likely to be assigned an emergency triage category compared with younger patients. This suggests that the elderly may be undertriaged and provides a potential area of study for reducing mortality and morbidity in older

Crossing international boundaries through doctoral partnerships: Learnings from a Chinese-Australian forum

International forums for doctoral students offer a fertile context for developing strategic partner-ships between higher education institutions, as well as for building the intercultural capacity of early career academics. However, there is limited research investigating the benefits of international doctoral forum partnerships. This paper presents learnings from a recent international doctoral forum held in Beijing, China and attended by doctoral students and academics from Beijing Normal University (China) and Queensland University of Technology (Australia). Drawing on qualitative case study method and a model of boundary crossing mechanisms, we identify the beneficial outcomes of the forum. We describe how the forum arose from a strong ongoing partnership between the Education Faculties of Beijing Normal University and Queensland University of Technology. We then identify how, at the institutional and individual level, international doctoral forum participants can be challenged and benefit in four areas: collaboration, intercultural capacity, academic enhancement and program development. Implications for engaging successfully in international doctoral forum partnerships are also discussed.

Social Media Audience Metrics as a New Form of TV Audience Measurement

Digital media have contributed to significant disruptions in the business of audience measurement. Television broadcasters have long relied on simple and authoritative measures of who is watching what. The demand for ratings data, as a common currency in transactions involving advertising and program content, will likely remain, but accompanying measurements of audience engagement with media content would also be of value. Today's media environment increasingly includes social media and second-screen use, providing a data trail that affords an opportunity to measure engagement. If the limitations of using social media to indicate audience engagement can be overcome, social media use may allow for quantitative and qualitative measures of engagement. Raw social media data must be contextualized, and it is suggested that tools used by sports analysts be incorporated to do so. Inspired by baseball's Sabremetrics, the authors propose Telemetrics in an attempt to separate actual performance from contextual factors. Telemetrics facilitates measuring audience activity in a manner controlling for factors such as time slot, network, and so forth. It potentially allows both descriptive and predictive measures of engagement.

The positioning of palliative care in acute care: A multiperspective qualitative study in the context of metastatic melanoma

Objective: The positioning and meaning of palliative care within the healthcare system lacks clarity which adds a level of complexity to the process of transition to palliative care. This study explores the transition to the palliative care process in the acute care context of metastatic melanoma. Method: A theoretical framework drawing on interpretive and critical traditions informs this research. The pragmatism of symbolic interactionism and the critical theory of Habermas brought a broad orientation to the research. Integration of the theoretical framework and grounded-theory methods facilitated data generation and analysis of 29 interviews with patients, family carers, and healthcare professionals. Results: The key analytical findings depict a scope of palliative care that was uncertain for users of the system and for those working within the system. Becoming “palliative” is not a defined event; nor is there unanimity around referral to a palliative care service. As such, ambiguity and tension contribute to the difficulties involved in negotiating the transition to palliative care. Significance of Results: Our findings point to uncertainty around the scopes of practice in the transition to palliative care. The challenge in the transition process lies in achieving greater coherency of care within an increasingly specialized healthcare system. The findings may not only inform those within a metastatic melanoma context but may contribute more broadly to palliative practices within the acute care setting.

Respite & Recoery at Al Wakra

International Design Competition for Qatar Psychiatric Hospital. The scheme for the Al Wakra Respite and Recovery Centre delivers on an all-in attitude toward evidence-based design. It sets new benchmarks in so many ways: the way it allows excellent separation between patient cohorts without unnecessary or visible restrictions; the way it allows sharing of most of the clinical kit and spaces; the way services reticulation and facilities management takes place without compromising security and safety; the ways It abandons the institutional axioms that are still so ubiquitous elsewhere, so it can appear as the friendly, welcoming and wholesome; the way it allows incredible flexibility to allow changes or flexion on the fly; the way it has such ‘good bones’ for more structural changes as the future unfolds. But most importantly, the scheme will be exemplary in the way the building itself plays a role in promoting the recovery and mental well-being of its residents. Like no other, the Centre will rise to the challenges of supporting and inspiring an exemplary mental health service and promote the well-being of the patients. The 160 bed scheme allows for 43,000m2 of landscape, packed with wholesome things to do and experience. The Aspire zone even has stables and a falconry, both to celebrate the love that Qatari people have for horses and birds.

Submission to the draft Migration Assurance Policy - Improving the transition to the fixed-line national broadband network review

The rights of individuals to self-determination and participation in social, political and economic life are recognised and supported by Articles 1, 3 and 25 of the International Covenant on Civil and Political Rights 1966.4 Article 1 of the United Nations’ Human Rights Council’s Resolution on the Promotion and Protection of Human Rights on the Internet of July 2012 confirms individuals have the same rights online as offline. Access to the internet is essential and as such the UN: Calls upon all States to promote and facilitate access to the Internet and international cooperation aimed at the development of media and information and communications facilities in all countries (Article 3) Accordingly, access to the internet per se is a fundamental human right, which requires direct State recognition and support.5 The obligations of the State to ensure its citizens are able, and are enabled, to access the internet, are not matters that should be delegated to commercial parties. Quite simply – access to the internet, and high-speed broadband, by whatever means are “essential services” and therefore “should be treated as any other utility service”...

In Perpetual Motion: Theories of Power, Educational History, and the Child

"In Perpetual Motion is an "historical choreography" of power, pedagogy, and the child from the 1600s to the early 1900s. It breaks new ground by historicizing the analytics of power and motion that have interpenetrated renditions of the young. Through a detailed examination of the works of John Locke, Jean-Jacques Rousseau, Johann Herbart, and G. Stanley Hall, this book maps the discursive shifts through which the child was given a unique nature, inscribed in relation to reason, imbued with an effectible interiority, and subjected to theories of power and motion. The book illustrates how developmentalist visions took hold in U.S. public school debates. It documents how particular theories of power became submerged and taken for granted as essences inside the human subject. In Perpetual Motion studiously challenges views of power as in or of the gaze, tracing how different analytics of power have been used to theorize what gazing could notice."--BOOK JACKET.

Dangerous Coagulations? The Uses of Foucault in the Study of Education

This book brings together an outstanding group of scholars who draw on the works of Michel Foucault. Eclectic in topic and method, the essays illustrate Foucault’s usefulness. Dangerous Coagulations? constitutes a departure from the more formulaic Foucault work that has emerged and highlights new possibilities for undertaking problematizing approaches to educational research.

Liability and statutory defence in Queensland

Context Increasing client awareness of valuer's duty of care - Webb Resolutions Ltd v E.Surv Ltd [2012] - Provident Capital Limited v John Virtue Pty Ltd (No 2) [2012] - Including disciplinary actions: Valuers Registration Board of Qld v Conroy [2013] QCAT 688 combined with Post-GFC ‘drops’ in value!

Factors influencing sustainability of health service innovation: Emergency nurse practitioner services

Introduction: Emergency department nurse practitioner services are one of the most frequently implemented service delivery models in Australian hospitals. This research examined factors influencing sustainability of this innovative service delivery model and offers some recommendations for future service integration. Background Many health service innovations have been implemented in an attempt to meet the growing demand for efficient, cost effective health care however, sustainability of many of these innovations has not been evaluated and is poorly understood. Aim The aim of the research was to identify factors that influence sustainability of emergency department nurse practitioner services and to operationalise a theoretical framework for evaluating innovation sustainability. Methodology The research used case study methodology. The case was emergency nurse practitioner services, and units of analysis were emergency department staff, emergency nurse practitioners and documents relating to nurse practitioner services. The data collection methods included, survey, one-on-one interviews, document analysis and telephone survey. Results This research shows that emergency nurse practitioner services partially comply with the factors of sustainability as described in the Sustainability of Innovation theoretical framework: Political, Organisational, Workforce, Financial and Innovation specific factors. Where services do not entirely meet the factors the existing benefits of the service may outweigh the barriers and other means of working around shortfalls are also implemented by staff to ensure patient safety. Conclusion The rapidly expanding emergency nurse practitioner service has been examined using case study methodology to find that certain factors may be threatening the sustainability of this health service innovation. Potentially an innovation may be sustained when only some factors are met in the short term, however, long term sustainability may be challenged if factors are not addressed and supported.

Hashtag as hybrid forum: The case of #agchatoz

This chapter imports Michel Callon’s model of the ‘hybrid forum’ (Callon et al, 2009, p. 18) into social media research, arguing that certain kinds of hashtag publics can be mapped onto this model. It explores this idea of the hashtag as hybrid forum through the worked example of #agchatoz—a hashtag used as both ‘meetup’ organizer for Australian farmers and other stakeholders in Australian agriculture, and as a topic marker for general discussion of related issues. Applying the principles and techniques of digital methods (Rogers, 2013), we employ a standard suite of analytics to a longitudinal dataset of #agchatoz tweets. The results are used not only to describe various elements and dynamics of this hashtag, but also to experiment with the articulation of such approaches with the theoretical model of the hybrid forum, as well as exploring the ways that controversies animate and transform such forums as part of the emergence and cross-pollination of issue publics.

Twitter hashtags from ad hoc to calculated publics

As the use of Twitter has become more commonplace throughout many nations, its role in political discussion has also increased. This has been evident in contexts ranging from general political discussion through local, state, and national elections (such as in the 2010 Australian elections) to protests and other activist mobilisation (for example in the current uprisings in Tunisia, Egypt, and Yemen, as well as in the controversy around Wikileaks). Research into the use of Twitter in such political contexts has also developed rapidly, aided by substantial advancements in quantitative and qualitative methodologies for capturing, processing, analysing, and visualising Twitter updates by large groups of users. Recent work has especially highlighted the role of the Twitter hashtag – a short keyword, prefixed with the hash symbol ‘#’ – as a means of coordinating a distributed discussion between more or less large groups of users, who do not need to be connected through existing ‘follower’ networks. Twitter hashtags – such as ‘#ausvotes’ for the 2010 Australian elections, ‘#londonriots’ for the coordination of information and political debates around the recent unrest in London, or ‘#wikileaks’ for the controversy around Wikileaks thus aid the formation of ad hoc publics around specific themes and topics. They emerge from within the Twitter community – sometimes as a result of pre-planning or quickly reached consensus, sometimes through protracted debate about what the appropriate hashtag for an event or topic should be (which may also lead to the formation of competing publics using different hashtags). Drawing on innovative methodologies for the study of Twitter content, this paper examines the use of hashtags in political debate in the context of a number of major case studies.

#auspol: The hashtag as community, event, and material object for engaging with Australian politics

Critical, loud, highly discursive and polarised; the #auspol hashtag represents a space, an event and a network for politically involved individuals to engage in and with Australian politics and speak to, at and about a variety of involved stakeholders. Contributors declare, debate and often berate each other’s opinions about current Australian politics. The hashtag itself is an important material object and engagement event involved within this performance of political participation. As a long-standing institution in the Twittersphere, and one studied by the authors and their colleagues since its early beginnings (Bruns and Burgess, 2011; Bruns and Stieglitz, 2012; 2013), the #auspol hashtag provides a potent case study through which to explore the discursive and affective dimensions of a hashtag public. This chapter that engages both empirically and theoretically with the use of this particular hashtag on Twitter to provide a qualitatively illustrated case in point for thinking about the long-term use of political hashtags as engagement events.