Do health inquiries lead to health system change? What have we learnt from recent health inquiries and will the same mistakes happen again?

Since 2001 there have been numerous Commissions of Inquiry into health system failures across the world. While the Inquiries were established to examine poor patient outcomes, each has identified a range of leadership and management shortcomings that have contributed to a poor standard of patient care. While there is an acknowledgement that different heath systems have different contexts, this paper highlights a number of themes that are common across Inquiries. It will discuss a number of common system failures in Inquiries spanning from 2001 to 2013 and pose questions as to why these types of failures are likely to re-occur, as well as possible learnings for health service management and leadership to address a number of these common themes.

Compression use during an exercise intervention and associated changes in breast cancer-related lymphoedema

Aim This study assessed the association between compression use and changes in lymphoedema observed in women with breast cancer-related lymphoedema who completed a 12 week exercise intervention. Methods This work uses data collected from a 12 week exercise trial, whereby women were randomly allocated into either aerobic-based only (n=21) or resistance-based only (n=20) exercise. Compression use during the trial was at the participant’s discretion. Differences in lymphoedema (measured by L-Dex score and inter-limb circumference difference [%]) and associated symptoms between those who wore, and did not wear compression during the 12 week intervention were assessed. We also explored participants’ reasons surrounding compression during exercise. Results No significant interaction effect between time and compression use for lymphoedema was observed. There was no difference between groups over time in the number or severity of lymphoedema symptoms. Irrespective of compression use, there were trends for reductions in the proportion of women reporting severe symptoms, but lymphoedema status did not change. Individual reasons for the use of compression, or lack thereof, varied markedly. Conclusion Our findings demonstrated an absence of a positive or negative effect from compression use during exercise on lymphoedema. Current and previous findings suggest the clinical recommendation that garments must be worn during exercise is questionable, and its application requires an individualised approach.

Single household domestic water heater design and control utilising PV energy: The untapped energy storage solution

Photovoltaic (PV) panels and electric domestic water heater with storage (DWH) are widely used in households in many countries. However, DWH should be explored as an energy storage mechanism before batteries when households have excess PV energy. Through a residential case study in Queensland, Australia, this paper presents a new optimized design and control solution to reduce water heating costs by utilizing existing DWH energy storage capacity and increasing PV self-consumption for water heating. The solution is produced by evaluating the case study energy profile and numerically maximizing the use of PV for DWH. A conditional probability matrix for different solar insolation and hot water usage days is developed to test the solution. Compared to other tariffs, this solution shows cost reduction from 20.8% to 63.3% This new solution could encourage solar households move to a more economical and carbon neutral water heating method.

Building capacity for cancer nursing research and evidence based practice: The cancer nursing professorial precinct initiative

The demand for cancer care is growing due to the increasing incidence of cancer and the improved effectiveness of cancer treatments. It is important that cancer nurses continue to improve patient outcomes through research and the use of evidence in practice development, education and policy. This paper describes a case report of a collaborative academic healthcare model that creates capacity for cancer nursing research and evidence-based practice. The Cancer Nursing Professorial Precinct is a strategic collaboration between the Royal Brisbane and Women’s Hospital (RBWH) and Queensland University of Technology (QUT), in Brisbane Australia. The outcomes of this initiative has been remarkable. The principles and strategies used in this initiative may be useful for cancer services in other countries.

Building local capacity to reduce road traffic injury in rapidly motorising countries

Road safety is a significant public health issue - 1.24m killed each year, 20-50m injured, 91% in rapidly motorising low/mid income countries Decade of Action for Road Safety 2011-2020: - National and local actions: “strengthening the management infrastructure and capacity for technical implementation of road safety activities at the national, regional and global levels” - Capacity as a constraint on a country’s action - Emphasis on knowledge/training – understand principles, promote training and education etc

LMS acceptance: The instructor role

Learning management systems (LMS) have become the norm in recent years in higher education to further engage students and lecturers. The e-learning tools within LMS provide knowledge sharing and community building opportunities that can support both critical thinking and higher order learning skills through conversation and collaboration. However, the mere existence of tools does not guarantee users’ adoption and acceptance. Several effective arrangements are required to engage users. This paper focuses on different aspects of lecturers’ attitude that impact user engagement with LMS tools reporting on findings from 74 interviews with students and lecturers from different disciplines within a major Australian university. Results indicate that lecturers’ teaching style and habits, active participation in online activities as well as designing appropriate tasks and assessment procedure are important determinants of lecturers’ attitude in engaging students with LMS tools.

Rail power conditioner technology in Australian Heavy Haul Railway: A case study

Aurizon, Australia's largest freight railway operator, is investigating the use of Rail Power Conditioner (RPC) technology for load balancing, reactive power compensation and harmonic filtering. The new technology has the capability of replacing Static VAr Compensators (SVC) and Harmonic Filters, and is expected to have a significant impact on the overall costs of railway electrification. This paper presents the theoretical analysis of the real and reactive power flows in an RPC used to balance active powers in an existing V/V feeder station. This informed an RPC feasibility study undertaken at four existing Aurizon's feeder stations with V/V connected transformers.

Residential tariff structure and battery energy storage impact in queensland LV network

Distributed renewable energy has become a significant contender in the supply of power in the distribution network in Queensland and throughout the world. As the cost of battery storage falls, distribution utilities turn their attention to the impacts of battery storage and other storage technologies on the low voltage (LV) network. With access to detailed residential energy usage data, Energex's available residential tariffs are investigated for their effectiveness in providing customers with financial incentives to move to Time-of Use based tariffs and to reward use of battery storage.

Preventing infections through cleaner hospitals (PITCH): An environmental cleaning bundle

Translating the numerous lengthy cleaning standards and guidelines into meaningful and sustained improvements in cleaning practice is challenging. This research hypothesized that an evidence based cleaning bundle would improve cleaning performance, knowledge and attitudes, and ultimately reduces healthcare associated infections (HAI) in a way that is value for money. A bundle is a small, straightforward set of evidence based practices, that when performed collectively and reliably, improves patient outcomes.

Harvest: A biotextile future

- Description of the work Harvest: A biotextile future consists of four bags constructed from kombucha, each utilizing a different approach to this material. The kombucha material is a byproduct of the fermented green tea, kombucha, and is comprised of a symbiotic culture of bacteria and yeast (SCOBY) that forms a fast growing curd or pellicle on the surface of the tea. This pellicle is harvested, washed, and dried to make a material with characteristics that can range between leather and paper in handle. The pellicle is one hundred per cent cellulose, with the individual fibres growing together to produce a durable and strong non-woven textile. Techniques explored with the dry kombucha material include folding, stitching, and laser etching. The final bags were designed with reference to classic tropes of fashion accessories: the briefcase, the clutch, the valise and the handbag. The valise included three jars in which the kombucha was displayed as ‘growing’ within the bag. - Research Background This work sits within an emerging field of practice in which fashion design intersects with biotechnology. Designers such as Suzanne Lee have explored constructing garments from bacteria byproducts, and bio-artists Oron Catts and Ionat Zurr have created ‘victimless leather’ grown from cultured cells. Although still speculative, these collaborations between science and design point to new material applications for fashion. Our work contributes to this area through testing both the growing of the textile and its application to construct durable fashion artefacts. - Research Contribution Harvest: A biotextile future makes two contributions to new knowledge in the area of design for sustainability within fashion. The first contribution lies in extending the technical experimentation required to grow and manipulate the textile. For the briefcase, the pattern shape was ‘grown’ into the required shape, using a shaped container. Other techniques used in the bags included weaving, folding and laser etching the material to extend its functional and decorative properties. Experimentation with the growing and drying of the material led to the production of a wide range of physical properties, in which the material was more brittle or flexible as required. The second research contribution lies in the proposal of this material for use in durable fashion accessories. The material is still speculative and small-scale in production, however the four bags illustrate the potential for kombucha as a biodegradable alternative to leather or synthetic materials. - Research Significance This interplay of science and design research opens up an exploration for a speculative future of sustainable, biodegradable textiles using live bacteria to enable ‘homegrown’ vegan apparel. The collaborators on this project include scientist Peter Musk and fashion designers Alice Payne and Dean Brough. Harvest: A biotextile future was exhibited at the State Library of Queensland’s Asia Pacific Design Library, 1-5 November 2015, as part of The International Association of Societies of Design Research’s (IASDR) biannual design conference. The work was chosen for display by a panel of experts, based on the criteria of design innovation and contribution to new knowledge in design.

Educational action research in Singapore: To prove or improve?

The rise of educational action research amongst schools in Singapore can be attributed to the government’s belief that educational research and reform can improve school performance and help Singapore keep pace with the impact of globalization. However, against a backdrop of neo-liberal educational reform where efficiency, accountability and demonstrable outcomes are valued, the underlying intent of the action research projects would seem to be inconsistent with the emancipatory intent normally associated with action research. A systematic review was conducted of 71 action research projects submitted to a local educational conference in 2006. Of concern to us is how action research has been narrowly interpreted and recruited simply as an evaluative tool with the emancipatory potential largely ignored. The paper is theoretically framed by governmentality and performativity to explore the embedded power relations that may “fabricate” the action research projects. The findings and discussions suggest a need for the government, schools and teacher-researchers to reflexively question the current expectation of action research and to be clear about its broader purpose

Professional learning places and spaces: The staffroom as a site of beginning teacher induction and transition

This paper argues that the staffroom is an important professional learning space where beginning teachers interact to understand who they are and the nature of their professional work. The authors highlight the theoretical importance of space and place in the construction and negotiation of beginning teacher subjectivities. To illustrate the staffroom as a particular place where important professional learning could occur the authors use two narratives based on the lived experiences of two beginning teachers, one in a primary context, the other secondary. The authors conclude by calling for greater research attention to the significance of the staffroom and its interaction with teacher subjectivities. At the level of practice we also call for the teaching profession to recognise staffrooms as important sites of professional learning and places that should support induction and mentoring of beginning teachers. Such recognition could enhance the retention, satisfaction, and effectiveness of new and experienced teachers alike.

Shrinking Violets

Description of the work Shrinking Violets is comprised of two half scale garments in laser cut silk organza, developed with a knotting device to allow for disassembly and reassembly. The first is a jacket in layered red organza including black storm flap details. The second is a vest in jade organza with circles of pink organza attached through a pattern of knots. Research Background This practice-led fashion design research sits within the field of Design for Sustainability (DfS) in fashion that seeks to mitigate the environmental and ethical impacts of fashion consumption and production. The research explores new systems of garment construction for DfS, and examines how these systems may involve ‘designing’ new user interactions with the garments. The garments’ construction system allows them to be disassembled and recycled or reassembled by users to form a new garment. Conventional garment design follows a set process of cutting and construction, with pattern pieces permanently machine-stitched together. Garments typically contain multiple fibre types; for example a jacket may be constructed from a shell of wool/polyester, an acetate lining, fusible interlinings, and plastic buttons. These complex inputs mean that textile recycling is highly labour intensive, first to separate the garment pieces and second to sort the multiple fibre types. This difficulty results in poor quality ‘shoddy’ comprised of many fibre types and unsuitable for new apparel, or in large quantities of recyclable textile waste sent to landfill (Hawley 2011). Design-led approaches that consider the garment’s end of life in the design process are a way of addressing this problem. In Gulich’s (2006) analysis, use of single materials is the most effective way to ensure ease of recycling, with multiple materials that can be detached next in effectiveness. Given the low rate of technological innovation in most apparel manufacturing (Ruiz 2011), a challenge for effective recycling is how to develop new manufacturing methods that allow for garments to be more easily disassembled at end-of-life. Research Contribution This project addresses the research question: How can design for disassembly be considered within the fashion design process? I have employed a practice-led methodology in which my design process leads the research, making use of methods of fashion design practice including garment and construction research, fabric and colour research, textile experimentation, drape, patternmaking, and illustration as well as more recent methods such as laser cutting. Interrogating the traditional approaches to garment construction is necessarily a technical process; however fashion design is as much about the aesthetic and desirability of a garment as it is about the garment’s pragmatics or utility. This requires a balance between the technical demands of designing for disassembly with the aesthetic demands of fashion. This led to the selection of luxurious, semi-transparent fabrics in bold floral colours that could be layered to create multiple visual effects, as well as the experimentation with laser cutting for new forms of finishing and fastening the fabrics together. Shrinking Violets makes two contributions to new knowledge in the area of design for sustainability within fashion. The first is in the technical development of apparel modularity through the system of laser cut holes and knots that also become a patterning device. The second contribution lies in the design of a system for users to engage with the garment through its ability to be easily reconstructed into a new form. Research Significance Shrinking Violets was exhibited at the State Library of Queensland’s Asia Pacific Design Library, 1-5 November 2015, as part of The International Association of Societies of Design Research’s (IASDR) biannual design conference. The work was chosen for display by a panel of experts, based on the criteria of design innovation and contribution to new knowledge in design. References Gulich, B. (2006). Designing textile products that are easy to recycle. In Y. Wang (Ed.), Recycling in Textiles (pp. 25-37). London: Woodhead. Hawley, J. M. (2011). Textile recycling options: exploring what could be. In A. Gwilt & T. Rissanen (Eds.), Shaping Sustainable Fashion: Changing the way we make and use clothes (pp. 143 - 155). London: Earthscan. Ruiz, B. (2014). Global Apparel Manufacturing. Retrieved 10 August 2014, from http://clients1.ibisworld.com/reports/gl/industry/default.aspx?entid=470

Teaching about deliberative politics: Case studies of classroom–community learning projects in four nations

Theories of deliberative politics position grass-roots community members as more than spectators of politics, and instead recognize their capacity for political engagement by discussing and evaluating options in order to make decisions about issues affecting community life. The processes and products of journalism can assist deliberative politics by providing community members with information resources that are vital for understanding the root causes of problems, weighing up competing claims, forming networks around shared concerns, reaching decisions and undertaking action. This article presents the findings of case studies of four community–classroom projects--one each from Australia, New Zealand, the United States and South Africa--that develop the capacity of journalism students to be effective contributors to deliberative politics. The research points to the importance of learning activities that prepare students to work in diverse communities, map significant community places and structures, identify leaders and stakeholders, engage in respectful dialogue about problems and perspectives, and appreciate community frames and values.

Stimulating immune responses to fight cancer: Basic biology and mechanisms

Chronic inflammation is now recognized as a major cause of malignant disease. In concert with various mechanisms (including DNA instability), hypoxia and activation of inflammatory bioactive lipid pathways and pro-inflammatory cytokines open the doorway to malignant transformation and proliferation, angiogenesis, and metastasis in many cancers. A balance between stimulatory and inhibitory signals regulates the immune response to cancer. These include inhibitory checkpoints that modulate the extent and duration of the immune response and may be activated by tumor cells. This contributes to immune resistance, especially against tumor antigen-specific T-cells. Targeting these checkpoints is an evolving approach to cancer immunotherapy, designed to foster an immune response. The current focus of these trials is on the programmed cell death protein 1 (PD-1) receptor and its ligands (PD-L1, PD-L2) and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4). Researchers have developed anti-PD-1 and anti-PDL-1 antibodies that interfere with the ligands and receptor and allow the tumor cell to be recognized and attacked by tumor-infiltrating T-cells. These are currently being studied in lung cancer. Likewise, CTLA-4 inhibitors, which have had success treating advanced melanoma, are being studied in lung cancer with encouraging results.