The concept of collaboration : a critical exploration of the care continuum

This thesis critically explored the concept of collaboration through an analysis of the experiences of midwives, child health nurses and women in the process of transition from hospital to community care and related policy documents. The research concluded that the concept serves an important social function in obscuring the complexity of social relations in healthcare. Rather than adopt an unquestioning attitude to what is represented as collaboration this thesis argues for a more critical examination of what is occurring, what is potentially hidden and how specific interests are served through its use.

Enriching community engaged learning through interdisciplinary collaboration

Twenty first century society presents critical challenges for higher education (Brew 2013, 2). The challenges facing modern communities require graduates to have skills that respond to issues at the boundaries of, and intersections between, disciplines. Mounting evidence suggests that interdisciplinary curriculum and pedagogies help students to develop boundary-crossing skills and a deeper awareness of the student’s domain-specific knowledge (Spelt et al. 2009; Strober 2011). Spelt et al. (2009) describe boundary-crossing skills as the ability to engage with different discourses, take account of multiple perspectives, synthesise knowledge of different disciplines, and cope with complexity. In this chapter we investigate emerging conditions, practical processes, and pedagogical strategies that are enabling the Lab stakeholders, the community, the university, and students to participate in interdisciplinary community-engaged learning. Aspects of the Lab that are considered in this chapter include building trust, sharing values, establishing learning goals that are reflected in learning experiences and assessment, and employing strategies that define and attend to relationships and roles. The case study, “The Recognition of Aboriginal and Torres Strait Islander Peoples in the Australian Constitution”, a QUT collaborative project with the Social Justice Research Unit Anglicare Southern Queensland, describes the collaborators, processes, outcomes, and the lessons learned through one Lab project over three semesters. The issues illustrated in the case study are then further explored in a critical discussion of the strategies supporting interdisciplinarity in community-engaged learning across university/community collaboration, within and across the university, and for student participants

Locating Indigenous Australia within community development practice : clients, consumers or change makers?

The philosophical promise of community development to “resource and empower people so that they can collectively control their own destinies” (Kenny 1996:104) is no doubt alluring to Indigenous Australia. Given the historical and contemporary experiences of colonial control and surveillance of Aboriginal bodies, alongside the continuing experiences of socio-economic disadvantage, community development reaffirms the aspirational goal of Indigenous Australians for self-determination. Self-determination as a national policy agenda for Indigenous Australians emerged in the 1970s and saw the establishment of a wide range of Aboriginal community-controlled services (Tsey et al 2012). Sullivan (2010:4) argues that the Aboriginal community controlled service sector during this time has, and continues to be, instrumental to advancing the plight of Indigenous Australians both materially and politically. Yet community development and self-determination remain highly problematic and contested in how they manifest in Indigenous social policy agendas and in practice (Hollinsworth 1996; Martin 2003; McCausland 2005; Moreton-Robinson 2009). Moreton-Robinson (2009:68) argues that a central theme underpinning these tensions is a reading of Indigeneity in which Aboriginal and Torres Strait Islander people, behaviours, cultures, and communities are pathologised as “dysfunctional” thus enabling assertions that Indigenous people are incapable of managing their own affairs. This discourse distracts us from the “strategies and tactics of patriarchal white sovereignty” that inhibit the “state’s earlier policy of self-determination” (Moreton-Robinson 2009:68). We acknowledge the irony of community development espoused by Ramirez above (1990), that the least resourced are expected to be most resourceful.; however, we wish to interrogate the processes that inhibit Indigenous participation and control of our own affairs rather than further interrogate Aboriginal minds as uneducated, incapable and/or impaired...

Identifying risk factors and protective factors for venous leg ulcer recurrence using a theoretical approach : a longitudinal study

Background The high recurrence rate of chronic venous leg ulcers has a significant impact on an individual’s quality of life and healthcare costs. Objectives This study aimed to identify risk and protective factors for recurrence of venous leg ulcers using a theoretical approach by applying a framework of self and family management of chronic conditions to underpin the study. Design Secondary analysis of combined data collected from three previous prospective longitudinal studies. Setting The contributing studies’ participants were recruited from two metropolitan hospital outpatient wound clinics and three community-based wound clinics. Participants Data were available on a sample of 250 adults, with a leg ulcer of primarily venous aetiology, who were followed after ulcer healing for a median follow-up time of 17 months after healing (range: 3 to 36 months). Methods Data from the three studies were combined. The original participant data were collected through medical records and self-reported questionnaires upon healing and every 3 months thereafter. A Cox proportion-hazards regression analysis was undertaken to determine the influential factors on leg ulcer recurrence based on the proposed conceptual framework. Results The median time to recurrence was 42 weeks (95% CI 31.9–52.0), with an incidence of 22% (54 of 250 participants) recurrence within three months of healing, 39% (91 of 235 participants) for those who were followed for six months, 57% (111 of 193) by 12 months, 73% (53 of 72) by two years and 78% (41 of 52) of those who were followed up for three years. A Cox proportional-hazards regression model revealed that the risk factors for recurrence included a history of deep vein thrombosis (HR 1.7, 95% CI 1.07–2.67, p=0.024), history of multiple previous leg ulcers (HR 4.4, 95% CI 1.84–10.5, p=0.001), and longer duration (in weeks) of previous ulcer (HR 1.01, 95% CI 1.003–1.01, p<0.001); while the protective factors were elevating legs for at least 30 minutes per day (HR 0.33, 95% CI 0.19–0.56, p<0.001), higher levels of self-efficacy (HR 0.95, 95% CI 0.92–0.99, p=0.016), and walking around for at least three hours/day (HR 0.66, 95% CI 0.44–0.98, p=0.040). Conclusions Results from this study provide a comprehensive examination of risk and protective factors associated with leg ulcer recurrence based on the chronic disease self and family management framework. These results in turn provide essential steps towards developing and testing interventions to promote optimal prevention strategies for venous leg ulcer recurrence.

Analysis of passenger group behaviour and its impact on passenger flow using an agent-based model

Group interaction within crowds is a common phenomenon and has great influence on pedestrian behaviour. This paper investigates the impact of passenger group dynamics using an agent-based simulation method for the outbound passenger process at airports. Unlike most passenger-flow models that treat passengers as individual agents, the proposed model additionally incorporates their group dynamics as well. The simulation compares passenger behaviour at airport processes and discretionary services under different group formations. Results from experiments (both qualitative and quantitative) show that incorporating group attributes, in particular, the interactions with fellow travellers and wavers can have significant influence on passengers activity preference as well as the performance and utilisation of services in airport terminals. The model also provides a convenient way to investigate the effectiveness of airport space design and service allocations, which can contribute to positive passenger experiences. The model was created using AnyLogic software and its parameters were initialised using recent research data published in the literature.

Dynamic agent composition for large-scale agent-based models

PURPOSE: This paper describes dynamic agent composition, used to support the development of flexible and extensible large-scale agent-based models (ABMs). This approach was motivated by a need to extend and modify, with ease, an ABM with an underlying networked structure as more information becomes available. Flexibility was also sought after so that simulations are set up with ease, without the need to program. METHODS: The dynamic agent composition approach consists in having agents, whose implementation has been broken into atomic units, come together at runtime to form the complex system representation on which simulations are run. These components capture information at a fine level of detail and provide a vast range of combinations and options for a modeller to create ABMs. RESULTS: A description of the dynamic agent composition is given in this paper, as well as details about its implementation within MODAM (MODular Agent-based Model), a software framework which is applied to the planning of the electricity distribution network. Illustrations of the implementation of the dynamic agent composition are consequently given for that domain throughout the paper. It is however expected that this approach will be beneficial to other problem domains, especially those with a networked structure, such as water or gas networks. CONCLUSIONS: Dynamic agent composition has many advantages over the way agent-based models are traditionally built for the users, the developers, as well as for agent-based modelling as a scientific approach. Developers can extend the model without the need to access or modify previously written code; they can develop groups of entities independently and add them to those already defined to extend the model. Users can mix-and-match already implemented components to form large-scales ABMs, allowing them to quickly setup simulations and easily compare scenarios without the need to program. The dynamic agent composition provides a natural simulation space over which ABMs of networked structures are represented, facilitating their implementation; and verification and validation of models is facilitated by quickly setting up alternative simulations.

The community and social impact of drink driving: Under the limit drink driving rehabilitation program

This video was prepared as a teaching resource for CARRS-Q's Under the Limit Drink Driving Rehabilitation Program

An agent-based approach to immune modelling

This study focuses on trying to understand why the range of experience with respect to HIV infection is so diverse, especially as regards to the latency period. The challenge is to determine what assumptions can be made about the nature of the experience of antigenic invasion and diversity that can be modelled, tested and argued plausibly. To investigate this, an agent-based approach is used to extract high-level behaviour which cannot be described analytically from the set of interaction rules at the cellular level. A prototype model encompasses local variation in baseline properties contributing to the individual disease experience and is included in a network which mimics the chain of lymphatic nodes. Dealing with massively multi-agent systems requires major computational efforts. However, parallelisation methods are a natural consequence and advantage of the multi-agent approach. These are implemented using the MPI library.

Considerations for a social and geographical framework for agent-based epidemics

Understanding the dynamics of disease spread is of crucial importance, in contexts such as estimating load on medical services to risk assessment and intervention policies against large-scale epidemic outbreaks. However, most of the information is available after the spread itself, and preemptive assessment is far from trivial. Here, we investigate the use of agent-based simulations to model such outbreaks in a stylised urban environment. For most diseases, infection of a new individual may occur from casual contact in crowds as well as from repeated interactions with social partners such as work colleagues or family members. Our model therefore accounts for these two phenomena.Presented in this paper is the initial framework for such a model, detailing implementation of geographical features and generation of social structures. Preliminary results are a promising step towards large-scale simulations and evaluation of potential intervention policies.

Model refinement through high-performance computing: an agent-based HIV example

Background Recent advances in Immunology highlighted the importance of local properties on the overall progression of HIV infection. In particular, the gastrointestinal tract is seen as a key area during early infection, and the massive cell depletion associated with it may influence subsequent disease progression. This motivated the development of a large-scale agent-based model. Results Lymph nodes are explicitly implemented, and considerations on parallel computing permit large simulations and the inclusion of local features. The results obtained show that GI tract inclusion in the model leads to an accelerated disease progression, during both the early stages and the long-term evolution, compared to a theoretical, uniform model. Conclusions These results confirm the potential of treatment policies currently under investigation, which focus on this region. They also highlight the potential of this modelling framework, incorporating both agent-based and network-based components, in the context of complex systems where scaling-up alone does not result in models providing additional insights.

Agent-based modelling of viral infection

The three phases of the macroscopic evolution of the HIV infection are well known, but it is still difficult to understand how the cellular-level interactions come together to create this characteristic pattern and, in particular, why there are such differences in individual responses. An 'agent-based' approach is chosen as a means of inferring high-level behaviour from a small set of interaction rules at the cellular level. Here the emphasis is on cell mobility and viral mutations.

A parallel approach to social network generation and agent-based epidemic simulation

Understanding the dynamics of disease spread is essential in contexts such as estimating load on medical services, as well as risk assessment and interven- tion policies against large-scale epidemic outbreaks. However, most of the information is available after the outbreak itself, and preemptive assessment is far from trivial. Here, we report on an agent-based model developed to investigate such epidemic events in a stylised urban environment. For most diseases, infection of a new individual may occur from casual contact in crowds as well as from repeated interactions with social partners such as work colleagues or family members. Our model therefore accounts for these two phenomena. Given the scale of the system, efficient parallel computing is required. In this presentation, we focus on aspects related to paralllelisation for large networks generation and massively multi-agent simulations.

Decentralised Communication in Autonomous Agent Swarms

Communication and information diffusion are typically difficult in situations where centralised structures may become unavailable. In this context, decentralised communication based on epidemic broadcast becomes essential. It can be seen as an opportunity-based flooding for message broadcasting within a swarm of autonomous agents, where each entity tries to share the information it possesses with its neighbours. As an example of applications for such a system, we present simulation results where agents have to coordinate to map an unknown area.

Community wide interventions for increasing physical activity [Updated with powerpoint slides]

Cochrane Journal Club resource for the Cochrane Systematic Review: Community wide interventions for increasing physical activity. The resource includes a power-point presentation describing the essential components of the paper, summary, Discussion points: a critical appraisal and an author profile.