The primacy of vital signs – Acute care nurses’ and midwives’ use of physical assessment skills: A cross sectional study

BACKGROUND: Registered nurses and midwives play an essential role in detecting patients at risk of deterioration through ongoing assessment and action in response to changing health status. Yet, evidence suggests that clinical deterioration frequently goes unnoticed in hospitalised patients. While much attention has been paid to early warning and rapid response systems, little research has examined factors related to physical assessment skills. OBJECTIVES: To determine a minimum data set of core skills used during nursing assessment of hospitalised patients and identify nurse and workplace predictors of the use of physical assessment to detect patient deterioration. DESIGN: The study used a single-centre, cross-sectional survey design. SETTING and PARTICIPANTS: The study included 434 registered nurses and midwives (Grades 5-7) involved in clinical care of patients on acute care wards, including medicine, surgery, oncology, mental health and maternity service areas, at a 929-bed tertiary referral teaching hospital in Southeast Queensland, Australia. METHODS: We conducted a hospital-wide survey of registered nurses and midwives using the 133-item Physical Assessment Skills Inventory and the 58-item Barriers to Registered Nurses’ Use of Physical Assessment scale. Median frequency for each physical assessment skill was calculated to determine core skills. To explore predictors of core skill utilisation, backward stepwise general linear modelling was conducted. Means and regression coefficients are reported with 95% confidence intervals. A p value < .05 was considered significant for all analyses. RESULTS: Core skills used by most nurses every time they worked included assessment of temperature, oxygen saturation, blood pressure, breathing effort, skin, wound and mental status. Reliance on others and technology (F = 35.77, p < .001), lack of confidence (F = 5.52, p = .02), work area (F = 3.79, p = .002), and clinical role (F = 44.24, p < .001) were significant predictors of the extent of physical assessment skill use. CONCLUSIONS: The increasing acuity of the acute care patient plausibly warrants more than vital signs assessment; however, our study confirms nurses’ physical assessment core skill set is mainly comprised of vital signs. The focus on these endpoints of deterioration as dictated by early warning and rapid response systems may divert attention from and devalue comprehensive nursing assessment that could detect subtle changes in health status earlier in the patient's hospitalisation.

Valuable learning, unwelcome assessment : what LLB and JD students really think about group work

This article contributes to current debates about the appropriate role of group work in legal curricula by providing insights into the attitudes of Bachelor of Laws (‘LLB’) and Juris Doctor (‘JD’) students towards such tasks. It begins by reviewing arguments for incorporating group work in legal education, both as a result of the recognition of its educational benefits, and as a response to increasing regulatory expectations regarding student collaboration skills. The article then reports the findings of a UNSW Law School Student Assessment Survey designed to determine how law students perceive group work and its assessment in law. One of the most striking findings is that many of the law students surveyed recognise and appreciate the learning and skills development benefits of group tasks, but are resistant to summative assessment of group work. Moreover, there are marked differences in attitude between LLB and JD students, and across year cohorts within those degrees. These findings suggest that further thought needs to be directed towards the specific purposes underpinning the choice of group work as a pedagogical tool, and assessment that is congruent with those purposes, taking into account the varying needs and experiences of different cohorts of students. The article concludes by considering whether meaningful group work can exist without summative assessment.

Rethinking board composition: Balancing competence and compatibility in director selection

Board composition is critical to board effectiveness. Shaping an effective board begins with the selection of directors. While much attention has been paid to the skills and qualifications directors require, there has been less focus on the necessity for board members to interact and work well together. This exploratory study offers insights into what qualities directors look for when selecting new members and the approach adopted to identify and select them. The findings of 10 in-depth interviews with Australian directors suggest new members are selected both on competencies and compatibility. Yet not all selection approaches adequately assess candidates for these two criteria. As a result many appointments fail to realise the selection criteria reducing capacity to reach its full potential.

Embedded creative workers and creative work in education

This article is concerned with the many connections between creative work and workers, and education work and industries. Employment in the education sector has long been recognised as a significant element in creative workers’portfolio careers. Much has been written, for exam- ple, about the positive contribution of ‘artists in schools’ initiatives. Australian census analyses reveal that education is the most common industry sector into which creative workers are ‘embedded’, outside of the core creative industries. However, beyond case studies and some survey research into arts instruction and instructors, we know remarkably little about in which education roles and sectors creative workers are embedded, and the types of value that they add in those roles and sectors. This article reviews the extant literature on creative work and workers in education, and presents the findings of a survey of 916 graduates from creative undergraduate degrees in Australia. The findings suggest that education work is very common among creative graduates indeed, while there are a range of motivating factors for education work among creative graduates, on average they are satisfied with their careers, and that creative graduates add significant creative-cultural and creative-generic value add through their work.

A New Start? : Implications of Work for the Dole on Mental Health of Unemployed Young Australians

This paper summarises literature on unemployment, mental health and Work for the Dole programs. Australian and international evidence suggests that unemployed young people are more likely to experience mental health problems than employed people (e.g. greater anxiety and depression, higher suicide rates). Drawing on research undertaken in Australia and overseas we identify a link between mental health and unemployment. However, there is a lack of firm evidence with respect to the impact of Work for the Dole programs on the mental health of unemployed young Australians. There is the possibility that with the Australian Government's proposed expansion of the program any benefits of Work for the Dole on mental health of young unemployed people could be diminished or lost. There is a clear need for more research in this area.

The 'gourmet' sausage factory: Keeping it human

Whilst tertiary institutions continue to invest heavily in the technological aspects of online Teaching & Learning (T&L), there does not appear to have been a commensurate investment in the “human” aspects of the use of the technology. Despite the broad recognition that teaching and learning materials need to be adapted for and to the onscreen medium, little attention appears to have been paid thus far to the actual people who are delivering it – who equally need to “adapt themselves” to that medium, in order to maximise the benefit of the technology by maximising the human communication skills of those using the online medium – as distinct from the technical skills required to drive and deliver the bits and bytes. The REdelivery Initiative was a direct response to that notion. This paper details – by way of a narrative of one of the workshop participants – that part of the process involving the professional development of academics specifically in and specifically for the digital, online, T&L context, in order to both illuminate and maximise the potential and opportunities afforded by the technology.

The "virtuous circle": A case study examining the case for better embedding of Work Integrated Learning approaches into university journalism cirriculums

This paper explores the potential to focus and develop the approach to Work Integrated Learning (WIL)in journalism courses where this method is seen as a core principal of the program. It argues that, in many cases, such approaches are ill-defined and underdeveloped, a fact that weakens the possibility for strong course outcomes. It then examines the particular case of QUT coverage of the 2014 G20 Leader's summit to illustrate how an all-of-course WIL approach to G20 coverage-coupled with a tailored interaction with the library-might provide an enhanced student experience as well as unlock the potential for greater knowledge transfer between university journalism courses and industry partners.

Women at work! evaluating equal employment policies and outcomes in construction

Purpose The purpose of this paper is to examine equal employment policies in Australia’s male-dominated construction industry and categorise the types of activities undertaken against an equal employment typology to identify links to outcomes for women in the form of increased participation and management. Design/methodology/approach To explore the issue of low representation of women in construction through the content analysis of 83 construction organisations’ equal employment opportunity (EEO) reports. Findings This industry is not engaging with equal employment issues and the numbers of women working in the industry and/or management are based on individual decision rather than an institutional commitment to equality in diversity. Research limitations/implications Australian legislation mandates organisational reporting of relevant data and offers public access to this information offering a unique data set. Practical implications An ageing population means that the predominately older male workforce is leaving construction in greater numbers with fewer potential replacements making new labour markets a vital consideration. Social implications Legislation and organisational policies designed to promote EEO for women have existed in numerous countries for decades. One objective of this legislation was to reduce male domination in senior positions and industries/occupations where women were under-represented. Despite this, few women are employed in construction in operational or management roles worldwide. Originality/value This study offers a comprehensive analysis of a male-dominated industry in one jurisdiction rather than a few selected cases and uses a broader rigorous typology for analysis that acknowledges both equal and different treatment options.

Journalism students' motivations and expectations of their work in comparative perspective

Based on a survey of 4,393 journalism students in Australia, Brazil, Chile, Mexico, South Africa, Spain, Switzerland, and the United States, this study provides much-needed comparative evidence about students’ motivations for becoming journalists, their future job plans, and expectations. Findings show not only an almost universal decline in students’ desire to work in journalism by the end of their program but also important national differences in terms of the journalistic fields in which they want to work, as well as their job expectations. The results reinforce the need to take into account national contexts when examining journalism education across the globe.

The validity of personal disturbance scale (DSSI/sAD) in people with diabetes mellitus, using longitudinal data

Despite being used since 1976, Delusions-Symptoms-States-Inventory/states of Anxiety and Depression (DSSI/sAD) has not yet been validated for use among people with diabetes. The aim of this study was to examine the validity of the personal disturbance scale (DSSI/sAD) among women with diabetes using Mater-University of Queensland Study of Pregnancy (MUSP) cohort data. The DSSI subscales were compared against DSM-IV disorders, the Mental Component Score of the Short Form 36 (SF-36 MCS), and Center for Epidemiologic Studies Depression Scale (CES-D). Factor analyses, odds ratios, receiver operating characteristic (ROC) analyses and diagnostic efficiency tests were used to report findings. Exploratory factor analysis and fit indices confirmed the hypothesized two-factor model of DSSI/sAD. We found significant variations in the DSSI/sAD domain scores that could be explained by CES-D (DSSI-Anxiety: 55%, DSSI-Depression: 46%) and SF-36 MCS (DSSI-Anxiety: 66%, DSSI-Depression: 56%). The DSSI subscales predicted DSM-IV diagnosed depression and anxiety disorders. The ROC analyses show that although the DSSI symptoms and DSM-IV disorders were measured concurrently the estimates of concordance remained only moderate. The findings demonstrate that the DSSI/sAD items have similar relationships to one another in both the diabetes and non-diabetes data sets which therefore suggest that they have similar interpretations.

Interrogating Creative Theory and Creative Work: Inside the Games Studio

The expansion of creative and cultural industries has provided a rich source for theoretical claims and commentary. Much of this reproduces and extends the idea that autonomy is the defining feature of both enterprises and workers. Drawing on evidence from research into Australian development studios in the global digital games industry, the article interrogates claims concerning autonomy and related issues of insecurity and intensity, skill and specialisation, work–play boundaries, identity and attachments. In seeking to reconnect changes in creative labour to the wider production environment and political economy, an argument is advanced that autonomy is deeply contextual and contested as a dimension of the processes of capturing value for firms and workers.

Investigation of pedestrian crashes on two-way two-lane rural roads in Ethiopia

Understanding pedestrian crash causes and contributing factors in developing countries is critically important as they account for about 55% of all traffic crashes. Not surprisingly, considerable attention in the literature has been paid to road traffic crash prediction models and methodologies in developing countries of late. Despite this interest, there are significant challenges confronting safety managers in developing countries. For example, in spite of the prominence of pedestrian crashes occurring on two-way two-lane rural roads, it has proven difficult to develop pedestrian crash prediction models due to a lack of both traffic and pedestrian exposure data. This general lack of available data has further hampered identification of pedestrian crash causes and subsequent estimation of pedestrian safety performance functions. The challenges are similar across developing nations, where little is known about the relationship between pedestrian crashes, traffic flow, and road environment variables on rural two-way roads, and where unique predictor variables may be needed to capture the unique crash risk circumstances. This paper describes pedestrian crash safety performance functions for two-way two-lane rural roads in Ethiopia as a function of traffic flow, pedestrian flows, and road geometry characteristics. In particular, random parameter negative binomial model was used to investigate pedestrian crashes. The models and their interpretations make important contributions to road crash analysis and prevention in developing countries. They also assist in the identification of the contributing factors to pedestrian crashes, with the intent to identify potential design and operational improvements.

Towards making informed decisions on selecting promising work zone safety treatments

Lack of detailed and accurate safety records on incidents in Australian work zones prevents a thorough understanding of the relevant risks and hazards. Consequently it is difficult to select appropriate treatments for improving the safety of roadworkers and motorists alike. This paper outlines development of a conceptual framework for making informed decisions about safety treatments by: 1) identifying safety issues and hazards in work zones; 2) understanding the attitudes and perceptions of both roadworkers and motorists; 3) reviewing the effectiveness of work zone safety treatments according to existing research, and; 4) incorporating local expert opinion on the feasibility and usefulness of the safety treatments. Using data collected through semi-structured interviews with roadwork personnel and online surveys of Queensland drivers, critical safety issues were identified. The effectiveness of treatments for addressing the issues was understood through rigorous literature review and consultations with local road authorities. Promising work zone safety treatments include enforcement, portable rumble strips, perceptual measures to imply reduced lane width, automated or remotely-operated traffic lights, end of queue measures, and more visible and meaningful signage.