Towards a smart cancer registry

Aims Pathology notification for a Cancer Registry is regarded as the most valid information for the confirmation of a diagnosis of cancer. In view of the importance of pathology data, an automatic medical text analysis system (Medtex) is being developed to perform electronic Cancer Registry data extraction and coding of important clinical information embedded within pathology reports. Methods The system automatically scans HL7 messages received from a Queensland pathology information system and analyses the reports for terms and concepts relevant to a cancer notification. A multitude of data items for cancer notification such as primary site, histological type, stage, and other synoptic data are classified by the system. The underlying extraction and classification technology is based on SNOMED CT1 2. The Queensland Cancer Registry business rules3 and International Classification of Diseases – Oncology – Version 34 have been incorporated. Results The cancer notification services show that the classification of notifiable reports can be achieved with sensitivities of 98% and specificities of 96%5, while the coding of cancer notification items such as basis of diagnosis, histological type and grade, primary site and laterality can be extracted with an overall accuracy of 80%6. In the case of lung cancer staging, the automated stages produced were accurate enough for the purposes of population level research and indicative staging prior to multi-disciplinary team meetings2 7. Medtex also allows for detailed tumour stream synoptic reporting8. Conclusions Medtex demonstrates how medical free-text processing could enable the automation of some Cancer Registry processes. Over 70% of Cancer Registry coding resources are devoted to information acquisition. The development of a clinical decision support system to unlock information from medical free-text could significantly reduce costs arising from duplicated processes and enable improved decision support, enhancing efficiency and timeliness of cancer information for Cancer Registries.

Perspectives about exercise from adults with venous leg ulcers : an exploratory study

Objective Exercise has the potential to offer a range of health benefits in addition to improving healing outcomes for people with venous leg ulcers. However despite evidence based recommendations, most of these individuals do not engage in regular exercise. The aim of this study was to gain an understanding of the perspectives of adults with venous leg ulcers, in relation to exercise. Method This was a qualitative design using semi-structured interviews and discussions. Ten participants with venous leg ulceration volunteered to participate. Recruitment was through a specialist wound clinic. Verbatim data were collected by an experienced moderator using a semi-structured guide. Data saturation was reached after three group discussions and two interviews. A random selection of transcripts was sent back to the participants for verification. Thematic content analysis was used to determine major themes and categories. Two transcripts were independently analysed, categories and themes independently developed, cross checked and found comparable. Remaining transcripts were analysed using developed categories and codes. Results Regardless of their current exercise routine, participants reported exercising prior to venous leg ulceration and expressed an interest in either becoming active or maintaining an active lifestyle. Overall four themes emerged from the findings: i) participant understanding of the relationship between chronic venous insufficiency and exercise patterns, ii) fear of harm impacts upon positive beliefs and attitudes to exercise, iii) perceived factors limit exercise and iv) structured management facilitates exercise. Conclusion The value of exercise in improving outcomes in venous leg ulcers lies in its capacity to promote venous return and reduce the risk of secondary conditions in this population. Despite motivation and interest in being exercise active, people with venous leg ulcers report many obstacles. Further exploration of mechanisms that assist this patient population and promote understanding about management of barriers, coupled with promotion of enabling factors is vital for improving their exercise participation.

Using a theory of planned behaviour framework to explore hand hygiene beliefs at the ‘5 critical moments’ among Australian hospital-based nurses

Background Improving hand hygiene among health care workers (HCWs) is the single most effective intervention to reduce health care associated infections in hospitals. Understanding the cognitive determinants of hand hygiene decisions for HCWs with the greatest patient contact (nurses) is essential to improve compliance. The aim of this study was to explore hospital-based nurses’ beliefs associated with performing hand hygiene guided by the World Health Organization’s (WHO) 5 critical moments. Using the belief-base framework of the Theory of Planned Behaviour, we examined attitudinal, normative, and control beliefs underpinning nurses’ decisions to perform hand hygiene according to the recently implemented national guidelines. Methods Thematic content analysis of qualitative data from focus group discussions with hospital-based registered nurses from 5 wards across 3 hospitals in Queensland, Australia. Results Important advantages (protection of patient and self), disadvantages (time, hand damage), referents (supportive: patients, colleagues; unsupportive: some doctors), barriers (being too busy, emergency situations), and facilitators (accessibility of sinks/products, training, reminders) were identified. There was some equivocation regarding the relative importance of hand washing following contact with patient surroundings. Conclusions The belief base of the theory of planned behaviour provided a useful framework to explore systematically the underlying beliefs of nurses’ hand hygiene decisions according to the 5 critical moments, allowing comparisons with previous belief studies. A commitment to improve nurses’ hand hygiene practice across the 5 moments should focus on individual strategies to combat distraction from other duties, peer-based initiatives to foster a sense of shared responsibility, and management-driven solutions to tackle staffing and resource issues. Hand hygiene following touching a patient’s surroundings continues to be reported as the most neglected opportunity for compliance.

Establishing and maintaining social connectivity: An understanding of the lived experiences of older adults residing in regional and rural communities

- Objective To better understand how to plan for an ageing demographic that resides in ever-changing community typologies. Design: Semi-structured in-depth interviews. - Setting Community settings in rural and regional towns in Queensland. - Participants Twenty-two people aged over 65 years living in regional and rural Australia. - Interventions Qualitative study of social connectedness. - Main outcome measure(s) Thematic qualitative analysis. - Results Formal and informal social contact, through family, friends and social groups, was found to be important to the everyday lives of the participants. - Conclusions Social connections for older adults are important in maintaining independence and community engagement.

Psychiatrists' views on pathways to care for people with schizophrenia in Vietnam

Objectives: Research about the outcomes of schizophrenia and the factors that determine them in developing countries is still limited. In this study, we interviewed experienced Vietnamese psychiatrists to examine their perspectives on outcome determinants in their country. The qualitative approach aimed to complement existing epidemiological knowledge and contribute to debate around the hypothesis that recovery is better in developing countries. Methods: Fifteen Vietnamese psychiatrists working in five leading psychiatric facilities participated in semi-structured interviews. Thematic content analysis of their expressed views identified three themes related to important outcome determinants in Vietnam: access to contemporary treatment, established patient-level prognostic indicators, and sociocultural variables. Results: The improving accessibility of modern treatment (including new medications, specialist staff and facilities) and increasing community adoption of a medical perspective on mental illness were seen as factors leading to improved outcomes, particularly in urban areas. However, some psychiatrists also identified the potentially beneficial nature of some aspects of Vietnamese society and culture being eroded by modernization, including traditional family structures, forms of employment and lifestyles. Conclusions: The perspectives of psychiatrists in this study suggest that socioeconomic change may be exerting conflicting influences on the outcomes of schizophrenia in Vietnam and other developing countries. Their views have implications in terms of how adequate treatment and support for people with severe mental illness can be provided in the context of limited resources, staffing and formal treatment options. Further research is needed to establish current recovery rates and prospectively explore the impact of modernization on outcomes.

Identifying safety beliefs among Australian electrical workers

The current study explored underlying beliefs regarding work safety among a sample of experienced Australian electrical workers. A qualitative research methodology using the theory of planned behavior as a framework was employed. A series of interviews and focus groups with licensed electrical workers (N = 46) were analyzed using thematic content analysis. Beliefs were classified as advantages (e.g. personal safety of self and co-workers), disadvantages (e.g., inconvenience to customer/clients and workload), referents (e.g., supervisors, work colleagues, customers), barriers (e.g., time and cost), and facilitators (e.g., training and knowledge, equipment availability) of safety adherence. The belief basis of the theory of planned behavior was a useful framework for exploring workers’ safety beliefs. The identified beliefs can inform future research about the important factors influencing safe work decisions and inform strategies to promote safer workplace decision making within the electrical safety context.

The construction of feminism in Indonesian film: Arisan 2!

Feminism in Indonesian society is related to the emancipation term that women nowadays have still been bringing up this issue. However, Arisan 2! film showed a shift in film discourse regarding the representation of cosmopolitan women in Indonesia. This research examines on how Arisan 2! film as a media portrays feminism in the society of Jakarta. Feminism in Arisan 2! film was likely to expose the liberal feminism in nowadays modern society through several issues of women’s emancipation, specifically in the areas of marriage, job, and social life.

Effective 20 newsgroups dataset cleaning

The rapid increase in the number of text documents available on the Internet has created pressure to use effective cleaning techniques. Cleaning techniques are needed for converting these documents to structured documents. Text cleaning techniques are one of the key mechanisms in typical text mining application frameworks. In this paper, we explore the role of text cleaning in the 20 newsgroups dataset, and report on experimental results.

Keeping kids sun safe: exploring parents' beliefs about their young child's sun-protective behaviours

Objectives Melanoma of the skin is the third most commonly diagnosed cancer in Australia. Given the high incidence of sunburn in children and the level of sun protection provided by parents is often infrequent and/or insufficient, this research employed qualitative methodology to examine parents' beliefs about their young child's sun safe behaviour. Methods Parents (N = 21; n = 14 mothers, n = 7 fathers) of children aged 2–5 years participated in focus groups to identify commonly held beliefs about their decision to sun protect their child. Data were analysed using thematic content analysis. Results Parents generally had knowledge of the broad sun safe recommendations; however, the specific details of the recommendations were not always known. Parents reported adopting a range of sun-protective measures for their child, which depended on the time of year. A range of advantages (e.g. reducing the risk of skin cancer, developing good habits early and parental peace of mind), disadvantages (e.g. false sense of safety and preventing vitamin D absorption), barriers (e.g. child refusal) and facilitators (e.g. routine and accessibility) to performing sun safe practices were identified. Normative pressures and expectations also affected parents' motivation to be sun safe for their child. Conclusions These identified beliefs can be used to inform interventions to improve sun safe behaviours in young children who reside in a region that has the highest skin cancer incidence in the world.

Planning for climate change adaptation in a neoliberal context: Influences and responses

This thesis explores how planning policy and practice is responding to the challenge of climate change, particularly in contexts where neoliberal rationales and practices frame decision making. It documents patterns of devolving government responsibilities and experiences of market based mechanisms before reporting on institutional and professional responses to these conditions. The research centred on a qualitative case study and involved thematic content analysis of policy documents and informant interviews. The contribution of the research and thesis is to establish the outlook for climate change adaptation under neoliberal conditions, and to introduce strategies for planners operating within these conditions.

Inducing shades of meaning by matrix methods : a first step towards thematic analysis of opinion

This article explores two matrix methods to induce the ``shades of meaning" (SoM) of a word. A matrix representation of a word is computed from a corpus of traces based on the given word. Non-negative Matrix Factorisation (NMF) and Singular Value Decomposition (SVD) compute a set of vectors corresponding to a potential shade of meaning. The two methods were evaluated based on loss of conditional entropy with respect to two sets of manually tagged data. One set reflects concepts generally appearing in text, and the second set comprises words used for investigations into word sense disambiguation. Results show that for NMF consistently outperforms SVD for inducing both SoM of general concepts as well as word senses. The problem of inducing the shades of meaning of a word is more subtle than that of word sense induction and hence relevant to thematic analysis of opinion where nuances of opinion can arise.

The product of text and 'Other' statements : discourse analysis and the critical use of Foucault

Much has been written on Michel Foucault’s reluctance to clearly delineate a research method, particularly with respect to genealogy (Harwood 2000; Meadmore, Hatcher, & McWilliam 2000; Tamboukou 1999). Foucault (1994, p. 288) himself disliked prescription stating, “I take care not to dictate how things should be” and wrote provocatively to disrupt equilibrium and certainty, so that “all those who speak for others or to others” no longer know what to do. It is doubtful, however, that Foucault ever intended for researchers to be stricken by that malaise to the point of being unwilling to make an intellectual commitment to methodological possibilities. Taking criticism of “Foucauldian” discourse analysis as a convenient point of departure to discuss the objectives of poststructural analyses of language, this paper develops what might be called a discursive analytic; a methodological plan to approach the analysis of discourses through the location of statements that function with constitutive effects.

The product of text and “Other” statements : discourse analysis and the critical use of Foucault

Much has been written on Michel Foucault’s reluctance to clearly delineate a research method, particularly with respect to genealogy (Harwood 2000; Meadmore, Hatcher, & McWilliam 2000; Tamboukou 1999). Foucault (1994, p. 288) himself disliked prescription stating, “I take care not to dictate how things should be” and wrote provocatively to disrupt equilibrium and certainty, so that “all those who speak for others or to others” no longer know what to do. It is doubtful, however, that Foucault ever intended for researchers to be stricken by that malaise to the point of being unwilling to make an intellectual commitment to methodological possibilities. Taking criticism of “Foucauldian” discourse analysis as a convenient point of departure to discuss the objectives of poststructural analyses of language, this paper develops what might be called a discursive analytic; a methodological plan to approach the analysis of discourses through the location of statements that function with constitutive effects.