The use of thermal imaging in assessing skin temperature following cryotherapy : a review

Nineteen studies met the inclusion criteria. A skin temperature reduction of 5–15 °C, in accordance with the recent PRICE (Protection, Rest, Ice, Compression and Elevation) guidelines, were achieved using cold air, ice massage, crushed ice, cryotherapy cuffs, ice pack, and cold water immersion. There is evidence supporting the use and effectiveness of thermal imaging in order to access skin temperature following the application of cryotherapy. Thermal imaging is a safe and non-invasive method of collecting skin temperature. Although further research is required, in terms of structuring specific guidelines and protocols, thermal imaging appears to be an accurate and reliable method of collecting skin temperature data following cryotherapy. Currently there is ambiguity regarding the optimal skin temperature reductions in a medical or sporting setting. However, this review highlights the ability of several different modalities of cryotherapy to reduce skin temperature.

The rest flies down the wind : complexities of late style in the work of Christina Stead

Examining the late style of a writer is like skirting around quicksand. End-of-career reflection can subvert long standing critical accounts; revisionist publishing histories or newly minted archival work can do likewise. And, as Nancy J. Troy suggests, an artist’s last thoughts are rarely planned as such (15). In the case of Christina Stead any consideration of late style is made more difficult because, chronologically speaking, her ‘late’ works were written some 20 years before her death in 1983. Thus chronology can be deceptive, as Nicholas Delbanco points out in Lastingness: The Art of Old Age. Stead’s last novel, I’m Dying Laughing The Humourist, was completed, at least in rough draft form in 1966, when Stead was 64, but friends and readers suggested many changes. The book was published posthumously in 1986. Stead’s work is receiving increasing critical attention so a discussion of her ‘late style’ is important, particularly given that her fiction seems to refuse so many attempts at category-making. This perspective reveals two interesting aspects of her late work: first her consistent engagement with the problems of age for women, and in particular women writers, and second, the consequence of a life-long attention to the representation of dialogic sound in her novels, a preoccupation that results in what can be termed an aural signature. My discussion refers to Edward Said’s and Nicholas Delbanco’s ideas about late style by way of a focus on selective biographical issues and Stead’s engagement with radical politics before moving to an examination of what can be called an aural signature in several novels. Her fiction demonstrates one of the agreed markers of late style: she was constantly looking forward and looking back through innovation in form and content.

Getting stuck in together : improving work integrated learning from an Australian institution and faculty perspective

According to a recent report Australian higher education is not in crisis. However, we could be doing it better. The report Mapping Australian Higher Education (Norton, 2012) highlights comparative weaknesses such as levels f student engagement; interactions between students and academic staff; and academic staff preferences for research over teaching. The report points out that despite these concerns most graduates continue to get good, well-paid jobs, student satisfaction is improving, and levels of public confidence in Australian higher education are high. It also stresses that ‘the promise of higher education is that it provides adaptable cognitive skills, not that it always provides the job specific skills graduates will need in their future employment’ (Norton, 2012, p.58). This is worth keeping in mind as we contribute to the significant growth in curriculum initiatives aimed at preparing graduates for the world of work. Work Integrated Learning (WIL) is not a new concept but there is increased pressure on higher education globally to address graduate employability skills. The sector is under pressure in an increasingly competitive environment to demonstrate the relevance of courses, accountability and effective use of public funds (Peach & Gamble, 2011). In the Australian context this also means responding to the skills shortage in areas such as engineering, health, construction and business (DEEWR, 2010). This paper provides a brief overview of collaborative efforts over several years to improve the activity of WIL at the Queensland University of Technology (QUT). These efforts have resulted in changes to curriculum, pedagogy, systems and processes, and the initiation of local, regional, national, and international networks. The willingness of students, staff, and industry partners to ‘get stuck in’ and try new approaches in these different contexts can be understood as a form of boundary spanning. That is, the development of the capability to mediate between different forms of expertise and the demands of different contexts in order to nurture student learning and improve the outcomes of higher education through WIL (Peach, Cates, Ilg, Jones, Lechleiter, 2011).

Challenges of Measuring Learning Outcomes for Property Students Engaged in Work Integrated Learning

Work integrated learning (WIL) or professional practice units are recognised as providing learning experiences that help students make successful transitions to professional practice. These units require students to engage in learning in the workplace; to reflect on this learning; and to integrate it with learning at university. However, an analysis of a recent cohort of property economics students at a large urban university provides evidence that there is great variation in work based learning experiences undertaken and that this impacts on students’capacity to respond to assessment tasks which involve critiquing these experiences in the form of reflective reports. This paper highlights the need to recognise the diversity of work based experiences; the impact this has on learning outcomes; and to find more effective and equitable ways of measuring these outcomes. The paper briefly discusses assessing learning outcomes in WIL and then describes the model of WIL in the Faculty of Built Environment and Engineering at the Queensland University of Technology (QUT). The paper elaborates on the diversity of students’ experiences and backgrounds including variations in the length of work experience, placement opportunities and conditions of employment.For example, the analysis shows that students with limited work experience often have difficulty critiquing this work experience and producing high level reflective reports. On the other hand students with extensive, discipline relevant work experience can be frustrated by assessment requirements that do not take their experience into account. Added to this the Global Financial Crisis (GFC) has restricted both part time and full time placement opportunities for some students. These factors affect students’ capacity to a) secure a relevant work experience, b) reflect critically on the work experiences and c) appreciate the impact the overall experience can have on their learning outcomes and future professional opportunities. Our investigation highlights some of the challenges faced in implementing effective and equitable approaches across diverse student cohorts. We suggest that increased flexibility in assessment requirements and increased feedback from industry may help address these challenges.

Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality

Background & aims: The confounding effect of disease on the outcomes of malnutrition using diagnosis-related groups (DRG) has never been studied in a multidisciplinary setting. This study aims to determine the prevalence of malnutrition in a tertiary hospital in Singapore and its impact on hospitalization outcomes and costs, controlling for DRG. Methods: This prospective cohort study included a matched case control study. Subjective Global Assessment was used to assess the nutritional status on admission of 818 adults. Hospitalization outcomes over 3 years were adjusted for gender, age, ethnicity, and matched for DRG. Results: Malnourished patients (29%) had longer hospital stays (6.9 ± 7.3 days vs. 4.6 ± 5.6 days, p < 0.001) and were more likely to be readmitted within 15 days (adjusted relative risk = 1.9, 95%CI 1.1–3.2, p = 0.025). Within a DRG, the mean difference between actual cost of hospitalization and the average cost for malnourished patients was greater than well-nourished patients (p = 0.014). Mortality was higher in malnourished patients at 1 year (34% vs. 4.1 %), 2 years (42.6% vs. 6.7%) and 3 years (48.5% vs. 9.9%); p < 0.001 for all. Overall, malnutrition was a significant predictor of mortality (adjusted hazard ratio = 4.4, 95% CI 3.3-6.0, p < 0.001). Conclusions: Malnutrition was evident in up to one third of the inpatients and led to poor hospitalization outcomes and survival as well as increased costs of care, even after matching for DRG. Strategies to prevent and treat malnutrition in the hospital and post-discharge are needed.

Choosing work and care : four Australian women negotiating return to paid work in the first year of motherhood

Australian women make decisions about return to paid work and care for their child within a policy environment that presents mixed messages about maternal employment and child care standards. Against this background an investigation of first-time mothers’ decision-making about workforce participation and child care was undertaken. Four women were studied from pregnancy through the first postnatal year using interview and diary methods. Inductive analyses identified three themes, all focused on dimensions of family security: financial security relating to family income, emotional security relating to child care quality, and pragmatic security relating to child care access. The current policy changes that aim to increase child care quality standards in Australia present a positive step toward alleviating family insecurities but are insufficient to alleviate the evidently high levels of tension between workforce participation and family life experienced by women transitioning back into the workforce in Australia.

Assessing for work integrated learning experiences : a pre-service teacher perspective

A critical aspect of the debate about work integrated learning in the university context is the blurring of boundaries and responsibilities in terms of student learning. In an Australian pre-service teacher education program this blurring of boundaries is apparent in stakeholder tensions about the nature and role of assessment during the practicum. In the study reported in this paper, students responded positively to the content of assessment tasks but maintained that their efforts to implement the associated planning in the workplace were stymied because of disparate understandings between university and school staff about the purpose of the task.

Quality of work life and turnover intention in primary healthcare organisations : a cross-sectional study of registered nurses in Saudi Arabia

Purpose: The purpose of this study was to improve the retention of primary healthcare (PHC) nurses through exploring and assessing their quality of work life (QWL) and turnover intention. Design and methods: A cross-sectional survey design was used in this study. Data were collected using a questionnaire comprising four sections (Brooks’ survey of Quality of Nursing Work Life [QNWL], Anticipated Turnover Intention, open-ended questions and demographic characteristics). A convenience sample was recruited from 143 PHC centres in Jazan, Saudi Arabia. A response rate of 87% (n = 508/585) was achieved. The SPSS v17 for Windows and NVivo 8 were used for analysis purposes. Procedures and tests used in this study to analyse the quantitative data were descriptive statistics, t-test, ANOVA, General Linear Model (GLM) univariate analysis, standard multiple regression, and hierarchical multiple regression. Qualitative data obtained from responses to the open-ended questions were analysed using the NVivo 8. Findings: Quantitative findings suggested that PHC nurses were dissatisfied with their work life. Respondents’ scores ranged between 45 and 218 (mean = 139.45), which is lower than the average total score on Brooks’ Survey (147). Major influencing factors were classified under four dimensions. First, work life/home life factors: unsuitable working hours, lack of facilities for nurses, inability to balance work with family needs and inadequacy of vacations’ policy. Second, work design factors: high workload, insufficient workforce numbers, lack of autonomy and undertaking many non-nursing tasks. Third, work context factors: management practices, lack of development opportunities, and inappropriate working environment in terms of the level of security, patient care supplies and unavailability of recreation room. Finally, work world factors: negative public image of nursing, and inadequate payment. More positively, nurses were notably satisfied with their co-workers. Conversely, 40.4% (n = 205) of the respondents indicated that they intended to leave their current employment. The relationships between QWL and demographic variables of gender, age, marital status, dependent children, dependent adults, nationality, ethnicity, nursing tenure, organisational tenure, positional tenure, and payment per month were significant (p < .05). The eta squared test for these demographics indicates a small to medium effect size of the variation in QWL scores. Using the GLM univariate analysis, education level was also significantly related to the QWL (p < .05). The relationships between turnover intention and demographic variables including gender, age, marital status, dependent children, education level, nursing tenure, organisational tenure, positional tenure, and payment per month were significant (p < .05). The eta squared test for these demographics indicates a small to moderate effect size of the variation in the turnover intention scores. Using the GLM univariate analysis, the dependent adults’ variable was also significantly related to turnover intention (p < .05). Turnover intention was significantly related to QWL. Using standard multiple regression, 26% of the variance in turnover intention was explained by the QWL F (4,491), 43.71, p < .001, with R² = .263. Further analysis using hierarchical multiple regression found that the total variance explained by the model as a whole (demographics and QWL) was 32.1%, F (17.433) = 12.04, p < .001. QWL explained an additional 19% of the variance in turnover intention, after controlling for demographic variables, R squared change =.19, F change (4, 433) = 30.190, p < .001. The work context variable makes the strongest unique contribution (-.387) to explain the turnover intention, followed by the work design dimension (-.112). The qualitative findings reaffirmed the quantitative findings in terms of QWL and turnover intention. However, the home life/work life and work world dimensions were of great important to both QWL and turnover intention. The qualitative findings revealed a number of new factors that were not included in the survey questionnaire. These included being away from family, lack of family support, social and cultural aspects, accommodation facilities, transportation, building and infrastructure of PHC, nature of work, job instability, privacy at work, patients and community, and distance between home and workplace. Conclusion: Creating and maintaining a healthy work life for PHC nurses is very important to improve their work satisfaction, reduce turnover, enhance productivity and improve nursing care outcomes. Improving these factors could lead to a higher QWL and increase retention rates and therefore reinforcing the stabilisation of the nursing workforce. Significance of the research: Many countries are examining strategies to attract and retain the health care workforce, particularly nurses. This study identified factors that influence the QWL of PHC nurses as well as their turnover intention. It also determined the significant relationship between QWL and turnover intention. In addition, the present study tested Brooks’ survey of QNWL on PHC nurses for the first time. The qualitative findings of this study revealed a number of new variables regarding QWL and turnover intention of PHC nurses. These variables could be used to improve current survey instruments or to develop new research surveys. The study findings could be also used to develop and appropriately implement plans to improve QWL. This may help to enhance the home and work environments of PHC nurses, improve individual and organisational performance, and increase nurses’ commitment. This study contributes to the existing body of research knowledge by presenting new data and findings from a different country and healthcare system. It is the first of its kind in Saudi Arabia, especially in the field of PHC. It has examined the relationship between QWL and turnover intention of PHC nurses for the first time using nursing instruments. The study also offers a fresh explanation (new framework) of the relationship between QWL and turnover intention among PHC nurses, which could be used or tested by researchers in other settings. Implications for further research: Review of the extant literature reveals little in-depth research on the PHC workforce, especially in terms of QWL and organisational turnover in developing countries. Further research is required to develop a QWL tool for PHC nurses, taking into consideration the findings of the current study along with the local culture. Moreover, the revised theoretical framework of the current study could be tested in further research in other regions, countries or healthcare systems in order to identify its ability to predict the level of PHC nurses’ QWL and their intention to leave. There is a need to conduct longitudinal research on PHC organisations to gain an in-depth understanding of the determents of and changes in QWL and turnover intention of PHC nurses at various points of time. An intervention study is required to improve QWL and retention among PHC nurses using the findings of the current study. This would help to assess the impact of such strategies on reducing turnover of PHC nurses. Focusing on the location of the current study, it would be valuable to conduct another study in five years’ time to examine the percentage of actual turnover among PHC nurses compared with the reported turnover intention in the current study. Further in-depth research would also be useful to assess the impact of the local culture on the perception of expatriate nurses towards their QWL and their turnover intention. A comparative study is required between PHC centres and hospitals as well as the public and private health sector agencies in terms of QWL and turnover intention of nursing personnel. Findings may differ from sector to sector according to variations in health systems, working environments and the case mix of patients.

Academics’ work and the concept of “profession” : an Australian case study

Universities in Australia and elsewhere have changed considerably in recent years. Inevitably, this has meant that the work of academics has also changed. Academics’ work is of importance because they are key players in universities and universities matter to the nation economically and intellectually in advancing knowledge and its practical application. Through the changes and challenges that have characterised academia in recent years, there is an assumption that academics’ work is representative of a profession. This research study investigates how academics construct their own perspectives regarding the academic "profession". The study is theoretically informed by Freidson’s theory that conceptualises professions as occupations if they are in control of their work rather than it being under the control of either the market or of their employing institutions. Two research questions guide this study. The first question investigates how academics might construct their work in ideal terms and the second one investigates the extent to which such constructions might constitute a "profession". A qualitative case study was conducted within two Australian universities. In all, twenty academics from ten disciplines took part in the study that consisted of a focus group and fifteen individual interviews. The study was conducted in three phases during which a conceptual framework of academics’ work was developed across three versions. This framework acted both a prompt to discussion and as a potential expression of academics’ work. The first version of the framework was developed from the literature during the first phase of the study. This early framework was used during the second phase of the study when five academics took part in a focus group. After the focus group, the second version of the framework was developed and used with fifteen academics in individual interviews during phase three of the study. The third version of the framework was the outcome of a synthesis of the themes that were identified in the data. The discussion data from the focus group and the individual interviews were analysed through a content analysis approach that identified four major themes. The first theme was that academics reported that their work would ideally be located within universities committed to using their expert knowledge to serve the world. The second theme was that academics reported that they wanted sufficient thinking time and reasonable workloads to undertake the intellectual work that they regard as their core responsibility, particularly in relation to undertaking research. They argued against heavy routine administrative workloads and sought a continuation of current flexible working arrangements. The third theme was that teaching qualifications should not be mandated but that there should be a continuation of the present practice of universities offering academics the opportunity to undertake formal teaching qualifications if they wish to. Finally, academics reported that they wanted values that have traditionally mattered to academia to continue to be respected and practised: autonomy, collegiality and collaborative relationships, altruism and service, and intellectual integrity. These themes are sympathetic to Freidson’s theory of professions in all but one matter: the non-mandatory nature of formal qualifications which he regards as absolutely essential for the performance of the complex intellectual work that characterises occupations that are professions. The study places the issue of academic professionalism on the policy agenda for universities wishing to identify academics’ work as a profession. The study contributes a theory-based and data-informed conceptual framework for academics’ work that can be considered in negotiating the nature and extent of their work. The framework provides a means of analysing what "academic professionalism" might mean; it adds specificity to such discussions by exploring a particular definition of profession, namely Freidson’s theory of professions as occupations that are in control of their own work. The study contributes to the development of theories around higher education concepts of academic professionalism and, in so doing, links that theoretical contribution to the wider professions field.

Teachers’ work in curricular markets : conditions of design and relations between the International Baccalaureate Diploma and the local curriculum

School level strategy enabled by neoliberal choice policies can produce internal curricular markets whereby branded curricula such as the International Baccalaureate are offered alongside the local government curriculum in the same school. This project investigated how such curricular markets operating in Australian schools impacted on teachers’ work. This paper reports on teachers work in three case study schools that offered both the International Baccalaureate Diploma program and the local senior schooling curriculum, then draws on an online survey of 225 teachers in 26 such schools across Australia. The analysis reveals the impact of curricular markets along two dimensions: the curriculum’s internal design; and the relational aspects of how schools manage to deliver tandem offerings within institutional constraints. Teachers working in the IBD Diploma program were shown to relish its design, despite additional demands, while teachers working in just the local curriculum reported more relational issues. The paper argues that these trends suggest that there are winners and losers emerging in the work conditions produced by curricular markets.  

Socioeconomic inequalities in weight status among mid-aged adults : the contribution of perceptions of weight status and weight-control behaviours

Background Socioeconomically-disadvantaged adults in developed countries experience a higher prevalence of a number of chronic diseases, such as cardiovascular disease, type 2 diabetes, osteoarthritis and some forms of cancer. Overweight and obesity are major risk factors for these diseases. Lower socioeconomic groups have a greater prevalence of overweight and obesity and this may contribute to their higher morbidity and mortality. International studies suggest that socioeconomic groups may differ in their self-perceptions of weight status and their engagement in weightcontrol behaviours (WCBs). Research has shown that lower socioeconomic adults are more likely to underestimate their weight status, and are less likely to engage in WCBs. This may contribute (in part) to the marked inequalities in weight status observed at the population level. There are few, and somewhat limited, Australian studies that have examined the types of weight-control strategies people adopt, the barriers to their weight control, the determinants of their perceived weight status and WCBs. Furthermore, there are no known Australian studies that have examined socioeconomic differences in these factors to better understand the reasons for socioeconomic inequalities in weight status. Hence, the overall aim of this Thesis is to examine why socioeconomically-disadvantaged group experience a greater prevalence of overweight and obesity than their more-advantaged counterparts. Methods This Thesis used data from two sources. Men and women aged 45 to 60 years were examined from both data source. First, the longitudinal Australian Diabetes, Obesity and Lifestyle (AusDiab) Study were used to advance our knowledge and understanding of socioeconomic differences in weight change, perceived weight status and WCBs. A total of 2753 participants with measured weights at both baseline (1999-2000) and follow-up (2004-2005) were included in the analyses. Percent weight change over the five-year interval was calculated and perceived weight status, WCBs and highest attained education were collected at baseline. Second, the Candidate conducted a postal questionnaire from 1013 Brisbane residents (69.8 % response rate) to investigate the relationship between socioeconomic position, determinants of perceived weight status, WCBs, and barriers and reasons to weight control. A test-retest reliability study was conducted to determine the reliability of the new measures used in the questionnaire. Most new measures had substantial to almost perfect reliability when considering either kappa coefficient or crude agreement. Results The findings from the AusDiab Study (accepted for publication in the Australian and New Zealand Journal of Public Health) showed that low-educated men and women were more likely to be obese at baseline compared to their higheducated respondents (O.R. = 1.97, 95 % C.I. = 1.30-2.98 and O.R. = 1.52, 95 % C.I. = 1.03-2.25, respectively). Over the five year follow-up period (1999-2000 to 2004- 05) there were no socioeconomic differences in weight change among men, however socioeconomically-disadvantaged women had greater weight gains. Participants perceiving themselves as overweight gained less weight than those who saw themselves as underweight or normal weight. There was no relationship between engaging in WCBs and five-year weight change. The postal questionnaire data showed that socioeconomically-disadvantaged groups were less likely to engage in WCBs. If they did engage in weight control, they were less likely to adopt exercise strategies, including moderate and vigorous physical activities but were more likely to decrease their sitting time to control their weight. Socioeconomically-disadvantaged adults reported more barriers to weight control; such as perceiving weight loss as expensive, requiring a lot of cooking skills, not being a high priority and eating differently from other people in the household. These results have been accepted for publication in Public Health Nutrition. The third manuscript (under review in Social Science and Medicine) examined socioeconomic differences in determinants of perceived weight status and reasons for weight control. The results showed that lower socioeconomic adults were more likely to specify the following reasons for weight control: they considered themselves to be too heavy, for occupational requirements, on recommendation from their doctor, family members or friends. Conversely, high-income adults were more likely to report weight control to improve their physical condition or to look more attractive compared with those on lower-incomes. There were few socioeconomic differences in the determinants of perceived weight status. Conclusions Education inequalities in overweight/obesity among men and women may be due to mis-perceptions of weight status; overweight or obese individuals in loweducated groups may not perceive their weight as problematic and therefore may not pay attention to their energy-balance behaviours. Socioeconomic groups differ in WCBs, and their reasons and perceived barriers to weight control. Health promotion programs should encourage weight control among lower socioeconomic groups. More specifically, they should encourage the engagement of physical activity or exercise and dietary strategies among disadvantaged groups. Furthermore, such programs should address potential barriers for weight control that disadvantaged groups may encounter. For example, disadvantaged groups perceive that weight control is expensive, requires cooking skills, not a high priority and eating differently from other people in the household. Lastly, health promotion programs and policies aimed at reducing overweight and obesity should be tailored to the different reasons and motivations to weight control experienced by different socioeconomic groups. Weight-control interventions targeted at higher socioeconomic groups should use improving physical condition and attractiveness as motivational goals; while, utilising social support may be more effective for encouraging weight control among lower socioeconomic groups.

Visual support for work assignment in process-aware information systems : framework formalisation and implementation

Process-aware information systems, ranging from generic workflow systems to dedicated enterprise information systems, use work-lists to offer so-called work items to users. In real scenarios, users can be confronted with a very large number of work items that stem from multiple cases of different processes. In this jungle of work items, users may find it hard to choose the right item to work on next. The system cannot autonomously decide which is the right work item, since the decision is also dependent on conditions that are somehow outside the system. For instance, what is “best” for an organisation should be mediated with what is “best” for its employees. Current work-list handlers show work items as a simple sorted list and therefore do not provide much decision support for choosing the right work item. Since the work-list handler is the dominant interface between the system and its users, it is worthwhile to provide an intuitive graphical interface that uses contextual information about work items and users to provide suggestions about prioritisation of work items. This paper uses the so-called map metaphor to visualise work items and resources (e.g., users) in a sophisticated manner. Moreover, based on distance notions, the work-list handler can suggest the next work item by considering different perspectives. For example, urgent work items of a type that suits the user may be highlighted. The underlying map and distance notions may be of a geographical nature (e.g., a map of a city or office building), but may also be based on process designs, organisational structures, social networks, due dates, calendars, etc. The framework proposed in this paper is generic and can be applied to any process-aware information system. Moreover, in order to show its practical feasibility, the paper discusses a full-fledged implementation developed in the context of the open-source workflow environment YAWL, together with two real examples stemming from two very different scenarios. The results of an initial usability evaluation of the implementation are also presented, which provide a first indication of the validity of the approach.

Low rank Runge-Kutta methods, symplecticity and stochastic Hamiltonian problems with additive noise

In this paper we extend the ideas of Brugnano, Iavernaro and Trigiante in their development of HBVM($s,r$) methods to construct symplectic Runge-Kutta methods for all values of $s$ and $r$ with $s\geq r$. However, these methods do not see the dramatic performance improvement that HBVMs can attain. Nevertheless, in the case of additive stochastic Hamiltonian problems an extension of these ideas, which requires the simulation of an independent Wiener process at each stage of a Runge-Kutta method, leads to methods that have very favourable properties. These ideas are illustrated by some simple numerical tests for the modified midpoint rule.