An exploratory ergonomic study of musculoskeletal disorder prevention in the Queensland Ambulance Service

From 2008-09 to 2012-13, the most prevalent worker compensation claim in the Queensland Ambulance Service (QAS) was musculoskeletal injuries at >80%. This is consistent with literature that shows Musculoskeletal Disorders (MSD) was one of the front runners for workplace injuries among many professions. In an attempt to reduce the injury rate and related claims, the QAS created a selection criterion for their workers based on the Health Related Fitness Test. This method intended to select workers based upon their fitness level, instead of selecting for their ability to perform the tasks or modify the tasks to better suit the workers. With injury rates remaining high, further research produced the Patient Handling Equipment Project Report, which provided the background for the Manual Handling Program Book. The Manual Handling Program Book however lacks in accurately addressing musculoskeletal hazards; actions which cause or avoid injury, correct posture and motion for patient movement, muscular biomechanics, static and dynamic workload including activities causing strain, and equipment use in relation to musculoskeletal hazards. The exploratory research aims to better understand the ambulance service’s perception of Manual Materials Handling (MMH), how it relates to musculoskeletal injuries and how the service has attempted to reduce its prevalence. Based on a literature review and a critical analysis of the QAS Health Related Fitness Test, QAS Patient Handling Equipment Project Report and the QAS Manual Handling Program Book, an understanding of their shortfalls in the prevention of musculoskeletal injuries was gained. This entails understanding the work tasks, workloads, strains and workflow of paramedics. This research creates a starting point for further research into musculoskeletal injuries in paramedics. This study specifically looks at hazards related to musculoskeletal disorders. It identifies work system deficiencies that contribute to the prevalence of musculoskeletal injuries, and possible interventions to avoid them in paramedics.

Australian pre-service teachers' Knowledge and understanding of cyberbullying: Implications for school climate

The beliefs, attitudes and understandings of pre-service teachers towards bullying and more recently, cyberbullying remains unclear. Previous studies have found them to be generally lacking confidence to address bullying, which could impact negatively on school climate if, when they enter the profession, these beliefs undermine existing anti-bullying initiatives. This study explores Australian pre-service teachers' (N= 717) understanding and knowledge of traditional bullying and cyberbullying and their confidence and capacity to deal with it. Findings from self-report, anonymous questionnaires from students attending three universities in Australia indicated that two thirds (66%) of current pre-service teachers felt informed to very informed and capable to very capable (62%) of dealing with school bullying and 90% could discern cyber and traditional bullying behaviours from other online and offline aggressive acts. Gender and Year level differences were found. The potential impact of their knowledge and understanding of bullying and cyberbullying on school climate, and sustaining and maintaining anti-bullying interventions as they enter the profession is discussed.

Adopting healthcare big data in Sri Lankan healthcare sector

The concept of big data has already outperformed traditional data management efforts in almost all industries. Other instances it has succeeded in obtaining promising results that provide value from large-scale integration and analysis of heterogeneous data sources for example Genomic and proteomic information. Big data analytics have become increasingly important in describing the data sets and analytical techniques in software applications that are so large and complex due to its significant advantages including better business decisions, cost reduction and delivery of new product and services [1]. In a similar context, the health community has experienced not only more complex and large data content, but also information systems that contain a large number of data sources with interrelated and interconnected data attributes. That have resulted in challenging, and highly dynamic environments leading to creation of big data with its enumerate complexities, for instant sharing of information with the expected security requirements of stakeholders. When comparing big data analysis with other sectors, the health sector is still in its early stages. Key challenges include accommodating the volume, velocity and variety of healthcare data with the current deluge of exponential growth. Given the complexity of big data, it is understood that while data storage and accessibility are technically manageable, the implementation of Information Accountability measures to healthcare big data might be a practical solution in support of information security, privacy and traceability measures. Transparency is one important measure that can demonstrate integrity which is a vital factor in the healthcare service. Clarity about performance expectations is considered to be another Information Accountability measure which is necessary to avoid data ambiguity and controversy about interpretation and finally, liability [2]. According to current studies [3] Electronic Health Records (EHR) are key information resources for big data analysis and is also composed of varied co-created values [3]. Common healthcare information originates from and is used by different actors and groups that facilitate understanding of the relationship for other data sources. Consequently, healthcare services often serve as an integrated service bundle. Although a critical requirement in healthcare services and analytics, it is difficult to find a comprehensive set of guidelines to adopt EHR to fulfil the big data analysis requirements. Therefore as a remedy, this research work focus on a systematic approach containing comprehensive guidelines with the accurate data that must be provided to apply and evaluate big data analysis until the necessary decision making requirements are fulfilled to improve quality of healthcare services. Hence, we believe that this approach would subsequently improve quality of life.

From maternity paper hand-held records to electronic health records: What do women tell us about their use?

The paper hand-held record (PHR) has been used extensively in general practice (GP) shared care management of pregnant women, and recently, the first Mater Shared Electronic Health Record (MSEHR) was introduced. The aim of this qualitative study was to examine women’s experiences using the records and the contribution of the records to integrate care. At the 36-week antenatal visit in a maternity tertiary centre clinic, women were identified as a user of either the PHR or the MSEHR and organised into Phase 1 and Phase 2 studies respectively. Fifteen women were interviewed in Phase 1 and 12 women in Phase 2. Semi-structured interviews were used for data collection, and analysed using qualitative content analysis. Four main themes were identified: (1) purpose of the record; (2) perceptions of the record; (3) content of the record, and; (4) sharing the record. Findings indicate that the PHR is a well-liked maternity tool. The findings also indicate there is under-usage of the MSEHR due to health-care providers failing to follow up and discuss the option of using the electronic health record option or if a woman has completed the log-in process. This paper adds to an already favourable body of knowledge about the use of the PHR. It is recommended that continued implementation of the MSEHR be undertaken to facilitate its use.

Beyond social justice agendas: Indigenous knowledges in pre-service teacher education and practice in Australia

The space and positioning of Indigenous knowledges (IK) within Australian curricula and pedagogy are often contentious, informed by the broader Australian socio-cultural, political and economic landscape. Against changing educational policy, historically based on the myth of terra nullius, we discuss the shifting priorities for embedding Indigenous knowledges in educational practice in university and school curricula and pedagogy. In this chapter, we argue that personal and professional commitment to social justice is an important starting point for embedding Indigenous knowledges in the Australian school curricula and pedagogy. Developing teacher knowledge around embedding IK is required to enable teachers’ preparedness to navigate a contested historical/colonising space in curriculum decision-making, teaching and learning. We draw one mpirical data from a recent research project on supporting pre-service teachers as future curriculum leaders; the project was funded by the Office of Learning and Teaching (OLT). This project aimed to support future curriculum leaders to develop their knowledge of embedding IK at one Australian university. We propose supporting the embedding of IK in situ with pre-service teachers and their supervising teachers on practicum in real, sustained and affirming ways that shifts the recognition of IK from personal commitment to social justice in education, to one that values Indigenous knowledges as content to educate (Connell, 1993). We argue that sustained engagement with and appreciation of IKhas the potential to decolonise Australian curricula, shift policy directions and enhance race relations between Indigenous and non-Indigenous Australians .

The role of emotion in product, service and business model design

Designers have become aware of the importance of creating strong emotional experiences intertwined with new tangible products for the past decade, however an increased interest from firms has emerged in developing new service and business models as complimentary forms of emotion-driven innovation. This interdisciplinary study draws from the psychological sciences – theory of emotion – and the management sciences – business model literature to introduce this new innovation agenda. The term visceral hedonic rhetoric (VHR) is defined as the properties of a product, (and in this paper service and business model extensions) that persuasively induce the pursuit of pleasure at an instinctual level of cognition. This research paper lays the foundation for VHR beyond a product setting, presenting the results from an empirical study where organizations explored the possibilities for VHR in the context of their business. The results found that firms currently believe VHR is perceived in either their product and/or services they provide. Implications suggest shifting perspective surrounding the use of VHR across a firm’s business model design in order to influence the outcomes of their product and/or service design, resulting in an overall stronger emotional connection with the customer.

Document timespan normalisation and understanding temporality for clinical records search

Previous qualitative research has highlighted that temporality plays an important role in relevance for clinical records search. In this study, an investigation is undertaken to determine the effect that the timespan of events within a patient record has on relevance in a retrieval scenario. In addition, based on the standard practise of document length normalisation, a document timespan normalisation model that specifically accounts for timespans is proposed. Initial analysis revealed that in general relevant patient records tended to cover a longer timespan of events than non-relevant patient records. However, an empirical evaluation using the TREC Medical Records track supports the opposite view that shorter documents (in terms of timespan) are better for retrieval. These findings highlight that the role of temporality in relevance is complex and how to effectively deal with temporality within a retrieval scenario remains an open question.

A framework for generating realistic traffic for distributed denial-of-service attacks and flash events

An intrinsic challenge associated with evaluating proposed techniques for detecting Distributed Denial-of-Service (DDoS) attacks and distinguishing them from Flash Events (FEs) is the extreme scarcity of publicly available real-word traffic traces. Those available are either heavily anonymised or too old to accurately reflect the current trends in DDoS attacks and FEs. This paper proposes a traffic generation and testbed framework for synthetically generating different types of realistic DDoS attacks, FEs and other benign traffic traces, and monitoring their effects on the target. Using only modest hardware resources, the proposed framework, consisting of a customised software traffic generator, ‘Botloader’, is capable of generating a configurable mix of two-way traffic, for emulating either large-scale DDoS attacks, FEs or benign traffic traces that are experimentally reproducible. Botloader uses IP-aliasing, a well-known technique available on most computing platforms, to create thousands of interactive UDP/TCP endpoints on a single computer, each bound to a unique IP-address, to emulate large numbers of simultaneous attackers or benign clients.

Implementation of a chest pain management service improves patient care and reduces length of stay

Objective Chest pain is one of the most common complaints in patients presenting to an emergency department. Delays in management due to a lack of readily available objective tests to risk stratify patients with possible acute coronary syndromes can lead to an unnecessarily lengthy admission placing pressure on hospital beds or inappropriate discharge. The need for a co-ordinated system of clinical management based on enhanced communication between departments, timely and appropriate triage, clinical investigation, diagnosis, and treatment was identified. Methods An evidence-based Chest Pain Management Service and clinical pathway were developed and implemented, including the introduction of after-hours exercise stress testing. Results Between November 2005 and March 2013, 5662 patients were managed according to a Chest Pain Management pathway resulting in a reduction of 5181 admission nights by more timely identification of patients at low risk who could then be discharged. In addition, 1360 days were avoided in high-risk patients who received earlier diagnosis and treatment. Conclusions The creation of a Chest Pain Management pathway and the extended exercise stress testing service resulted in earlier discharge for low-risk patients; and timely treatment for patients with positive and equivocal exercise stress test results. This service demonstrated a significant saving in overnight admissions.

Changing travel patterns and journeys to health services in Great Britain 1985-2012: An examination health service utilisation using the National Travel Survey

Background This paper examines changing patterns in the utilisation and geographic access to health services in Great Britain using National Travel Survey data (1985-2012). The National Travel Survey (NTS) is a series of household surveys designed to provide data on personal travel and monitor changes in travel behaviour over time. The utilisation rate was derived using the proportion of journeys made to access health services. Geographic access was analysed by separating the concept into its accessibility and mobility dimensions. Methods Variables from the PSU, households, and individuals datasets were used as explanatory variables. Whereas, variables extracted from the journeys dataset were used as dependent variables to identify patterns of utilisation i.e. the proportion of journeys made by different groups to access health facilities in a particular journey distance or time band or by mode of transport; and geographic access to health services. A binary logistic regression analysis was conducted to identify the utilisation rate over the different time periods between different groups. This analysis shows the Odds Ratios (ORs) for different groups making a trip to utilise health services compared to their respective counterparts. Linear multiple regression analyses were conducted to then identify patterns of change in the accessibility and mobility level. Results Analysis of the data has shown that that journey distances to health facilities were signi fi cantly shorter and also gradually reduced over the period in question for Londoners, females, those without a car or on low incomes, and older people. Although rates of utilisation of health services we re Oral Abstracts / Journal of Transport & Health 2 (2015) S5 – S63 S43 signi fi cantly lower because of longer journey times. These fi ndings indicate that the rate of utilisation of health services largely depends on mobility level although previous research studies have traditionally overlooked the mobility dimension. Conclusions This fi nding, therefore, suggests the need to improve geographic access to services together with an enhanced mobility option for disadvantaged groups in order for them to have improved levels of access to health facilities. This research has also found that the volume of car trips to health services also increased steadily over the period 1985-2012 while all other modes accounted for a smaller number of trips. However, it is dif fi cult to conclude from this research whether this increase in the volume of car trips was due to a lack of alternative transport or due to an increase in the level of car-ownership.

Empirical insights into the development of a service-oriented enterprise architecture

Organisations use Enterprise Architecture (EA) to reduce organisational complexity, improve communication, align business and information technology (IT), and drive organisational change. Due to the dynamic nature of environmental and organisational factors, EA descriptions need to change over time to keep providing value for its stakeholders. Emerging business and IT trends, such as Service-Oriented Architecture (SOA), may impact EA frameworks, methodologies, governance and tools. However, the phenomenon of EA evolution is still poorly understood. Using Archer's morphogenetic theory as a foundation, this research conceptualises three analytical phases of EA evolution in organisations, namely conditioning, interaction and elaboration. Based on a case study with a government agency, this paper provides new empirically and theoretically grounded insights into EA evolution, in particular in relation to the introduction of SOA, and describes relevant generative mechanisms affecting EA evolution. By doing so, it builds a foundation to further examine the impact of other IT trends such as mobile or cloud-based solutions on EA evolution. At a practical level, the research delivers a model that can be used to guide professionals to manage EA and continually evolve it.

Integrated Chronic Disease Nurse Practitioner Service: Evaluation Final Report

Executive Summary Queensland University of Technology (QUT) was contracted to conduct an evaluation of an integrated chronic disease nurse practitioner service conducted at Meadowbrook Primary Care Practice. This evaluation is a collaborative project with nurse practitioners (NP) from Logan Hospital. The integrated chronic disease nurse practitioner service is an outpatient clinic for patients with two or more chronic diseases, including chronic kidney disease (CKD), heart failure (HF), diabetes (type I or II). This document reports on the first 12 months of the service (4th June, 2014 to 25th May, 2015). During this period: • 55 patients attended the NP clinic with 278 occasions of service provided • Almost all (95.7%) patients attended their scheduled appointments (only 4.3% did not attend an appointment) • Since attending the NP clinic, the majority of patients (77.6%) had no emergency department visits related to their chronic disease; only 3 required hospital admission. • 3 patients under the service were managed with Hospital In the Home which avoided more than 25 hospital bed days • 41 patients consented to join a prospective cohort study of patient-reported outcomes and patient satisfaction • 14 patient interviews and 3 stakeholder focus groups were also conducted to provide feedback on their perceptions of the NP-led service innovation. The report concludes with seven recommendations.

Controlling routine front line service workers: an Australian retail supermarket case

Food retail is known for its use of flexible labour and for the centralisation of functions at head office, resulting in a reduction of managerial autonomy at store level. This article employs a typology of controls developed from labour process scholarship to explore how retail managers negotiate the control of their predominantly part-time workforce. Using an Australian supermarket chain as a case, and mixed methods, the article demonstrates that supermarkets use a multiplicity of forms of control across their workforce. For front line service workers, the article identifies a new configuration of controls which intersects with employment status and acts differentially for checkout operators on different employment contracts.

Introduction to "Business innovation and disruption in the music industry"

Similar to most other creative industries, the evolution of the music industry is heavily shaped by media technologies. This was equally true in 1999, when the global recorded music industry had experienced two decades of continuous growth largely driven by the rapid transition from vinyl records to Compact Discs. The transition encouraged avid music listeners to purchase much of their music collections all over again in order to listen to their favourite music with ‘digital sound’. As a consequence of this successful product innovation, recorded music sales (unit measure) more than doubled between the early 1980s and the end of the 1990s. It was with this backdrop that the first peer-to-peer file sharing service was developed and released to the mainstream music market in 1999 by the college student Shawn Fanning. The service was named Napster and it marks the beginning of an era that is now a classic example of how an innovation is able to disrupt an entire industry and make large swathes of existing industry competences obsolete. File sharing services such as Napster, followed by a range of similar services in its path, reduced physical unit sales in the music industry to levels that had not been seen since the 1970s. The severe impact of the internet on physical sales shocked many music industry executives who spent much of the 2000s vigorously trying to reverse the decline and make the disruptive technologies go away. At the end, they learned that their efforts were to no avail and the impact on the music industry proved to be transformative, irreversible and, to many music industry professionals, also devastating. Thousands of people lost their livelihood, large and small music companies have folded or been forced into mergers or acquisitions. But as always during periods of disruption, the past 15 years have also been very innovative, spurring a plethora of new music business models. These new business models have mainly emerged outside the music industry and the innovators have been often been required to be both persuasive and persistent in order to get acceptance from the risk-averse and cash-poor music industry establishment. Apple was one such change agent that in 2003 was the first company to open up a functioning and legal market for online music. iTunes Music Store was the first online retail outlet that was able to offer the music catalogues from all the major music companies; it used an entirely novel pricing model, and it allowed consumers to de-bundle the music album and only buy the songs that they actually liked. Songs had previously been bundled by physical necessity as discs or cassettes, but with iTunes Music Store, the institutionalized album bundle slowly started to fall apart. The consequences had an immediate impact on music retailing and within just a few years, many brick and mortar record stores were forced out of business in markets across the world. The transformation also had disruptive consequences beyond music retailing and redefined music companies’ organizational structures, work processes and routines, as well as professional roles. iTunes Music Store in one sense was a disruptive innovation, but it was at the same time relatively incremental, since the major labels’ positions and power structures remained largely unscathed. The rights holders still controlled their intellectual properties and the structures that guided the royalties paid per song that was sold were predictable, transparent and in line with established music industry practices.

Response to: Electronic health records and healthcare identifiers : legislation discussion paper

Public submission # 029 to a Australian federal parliamentary committee considering proposed legislative changes to the Commonwealth's Healthcare Identifiers Act 2010 and the Personally Controlled Electronic Health Records Act 2012.