But what makes it doctoral? Taking on the traditionalists : interdisciplinary, practice-led doctoral research in the creative industries - a case study in academic politics, research, rigour and relevance

This paper examines a Doctoral journey of interdisciplinary exploration, explication, examination...and exasperation. In choosing to pursue a practice-led doctorate I had determined from the outset that ‘writing 100,000 words that only two people ever read’, was not something which interested me. Hence, the oft-asked question of ‘what kind of doctorate’ I was engaged in, consistently elicited the response, “a useful one”. In order to satisfy my own imperatives of authenticity and usefulness, my doctoral research had to clearly demonstrate relevance to; productively inform; engage with; and add value to: wider professional field(s) of practice; students in the university courses I teach; and the broader community - not just the academic community. Consequently, over the course of my research, the question, ‘But what makes it Doctoral?’ consistently resounded and resonated. Answering that question, to satisfy not only the traditionalists asking it but, perhaps surprisingly, some academic innovators - and more particularly, myself as researcher - revealed academic/political inconsistencies and issues which challenged both the fundamental assumptions and actuality of practice-led research. This paper examines some of those inconsistencies, issues and challenges and provides at least one possible answer to the question: ‘But what makes it Doctoral?’

Dietetic practice by Australian and Canadian dietitians with people with Parkinson's disease

Although Parkinson’s disease (PD) is a complex disease for which appropriate nutrition management is important, limited evidence is currently available to support dietetic practice. Existing PD-specific guidelines do not span all phases of the Nutrition Care Process (NCP). This study aimed to document PD-specific nutrition management practice by Australian and Canadian dietitians. DAA members and PEN subscribers were invited to participate in an online survey (late 2011). Eighty-four dietitians responded (79.8% Australian). The majority (70.2%) worked in the clinical setting. Existing non-PD guidelines were used by 52.4% while 53.6% relied on self-initiated literature reviews. Weight loss/malnutrition, protein intake, dysphagia and constipation were common issues in all NCP phases. Respondents also requested more information/evidence for these topics. Malnutrition screening (82.1%) and assessment (85.7%) were routinely performed. One-third did not receive referrals for weight loss for overweight/obesity. Protein intake meeting gender/age recommendations (69.0%), and high energy/high protein diets to manage malnutrition (82.1%) were most commonly used. Constipation management was through high fibre diets (86.9%). Recommendations for spacing of meals and PD medications varied with 34.5% not making recommendations. Nutritional diagnosis (70.2%) and stage of disease (61.9%) guided monitoring frequency. Common outcome measures included appropriate weight change (97.6%) and regular bowel movements (88.1%). With limited PD-specific guidance, dietitians applied best available evidence for other groups with similar issues. Dietitians requested evidence-based guidelines specifically for the nutritional management of PD. Guideline development should focus on those areas reported as commonly encountered. This process can identify the gaps in evidence to guide future research.

CPD : Using evidence based clinical practice guidelines in the management of anaemia in patients with chronic renal failure

Anaemia is a chronic problem in patients with renal insufficiency, especially chronic renal failure (CRF). In patients with CRF, anaemia is primarily due to a deficiency in erythropoietin (EPO), a glycoprotein growth factor that stimulates RBC production. The long-term effects and burden of anaemia for patients with CRF can be physical, emotional and financial. With efficient, systematic management of anaemia, clinicians have the potential to realise not only better clinical outcomes for CRF patients but also significant cost savings for them and the health system. During the last decade, significant advances have been made in clinicians’ understanding of how best to manage anaemia in this vulnerable population. One of the most important efforts to improve clinical practice has been the development of best practice guidelines.

Point-to-point speed enforcement : recommendations for better practice

Point-to-point speed cameras are a relatively new and innovative technological approach to speed enforcement that is increasingly been used in a number of highly motorised countries. Previous research has provided evidence of the positive impact of this approach on vehicle speeds and crash rates, as well as additional traffic related outcomes such as vehicle emissions and traffic flow. This paper reports on the conclusions and recommendations of a large-scale project involving extensive consultation with international and domestic (Australian) stakeholders to explore the technological, operational, and legislative characteristics associated with the technology. More specifically, this paper provides a number of recommendations for better practice regarding the implementation of point-to-point speed enforcement in the Australian and New Zealand context. The broader implications of the research, as well as directions for future research, are also discussed.

A pilot study on understanding the journey of advanced prostate cancer patients

Objective: To understand the journey of advanced prostate cancer patients for supporting development of an innovative patient journey browser. Background: Prostate cancer is one of the common cancers in Australia. Due to the chronic nature of the disease, it is important to have effective disease management strategy and care model. Multi-disciplinary care is a well-proven approach for chronic disease management. The Multi-disciplinary team (MDT) can function more effectively if all the required information is available for the clinical decision support. The development of innovative technology relies on an accurate understanding of the advanced prostate cancer patient’s journey over a prolonged period. This need arises from the fact that advanced prostate cancer patients may follow various treatment paths and change their care providers. As a result of this, it is difficult to understand the actual sources of patient’s clinical records and their treatment patterns. The aim of the research is to understand variable sources of clinical records, treatment patterns, alternative therapies, over the counter (OTC) medications of advanced prostate cancer patients. This study provides better and holistic understanding of advanced prostate cancer journey. Methods: The study was conducted through an on-line survey developed to seek and analyse the responses from the participants. The on-line questionnaire was carefully developed through consultations with the clinical researchers at the Australian Prostate Cancer Research Centre-Queensland, prostate cancer support group representatives and health informaticians at the Australian e-Health Research Centre. The non-identifying questionnaire was distributed to the patients through prostate cancer support groups in Queensland, Australia. The pilot study was carried out between August 2010 and December 2010. Results: The research made important observations about the advanced prostate cancer journey. It showed that General Practitioner (GP) was the common source of patient’s clinical records (41%) followed by Urologist (14%) and other clinicians (14%). The data analysis also showed that selenium was the common complementary supplement (55%) used by the patients and about 48% patients did not use any OTC drugs. The most common OTC used by the patients was Paracetamol (about 45%). Conclusion: The results have provided a foundation to the architecture of the proposed technology solution. The outcomes of this study are incorporated in design of the proposed patient journey browser system. A basic version of the system is currently being used at the advanced prostate cancer MDT meetings.

Higher-order non-linear analysis of steel structures. Part II : refined plastic hinge formulation

In the companion paper, a fourth-order element formulation in an updated Lagrangian formulation was presented to handle geometric non-linearities. The formulation of the present paper extends this to include material non-linearity by proposing a refined plastic hinge approach to analyse large steel framed structures with many members, for which contemporary algorithms based on the plastic zone approach can be problematic computationally. This concept is an advancement of conventional plastic hinge approaches, as the refined plastic hinge technique allows for gradual yielding, being recognized as distributed plasticity across the element section, a condition of full plasticity, as well as including strain hardening. It is founded on interaction yield surfaces specified analytically in terms of force resultants, and achieves accurate and rapid convergence for large frames for which geometric and material non-linearity are significant. The solutions are shown to be efficacious in terms of a balance of accuracy and computational expediency. In addition to the numerical efficiency, the present versatile approach is able to capture different kinds of material and geometric non-linearities on general applications of steel structures, and thereby it offers an efficacious and accurate means of assessing non-linear behaviour of the structures for engineering practice.

On the advanced analysis of steel frames allowing for flexural, local and lateral-torsional buckling

Detailed procedure for second-order analysis has been coded in the newest Eurocode 3 and the Hong Kong steel code (2005). The effective length method has been noted to be inapplicable to analysis of shallow domes of imperfect members exhibiting snap-through buckling, to portals with leaning columns and others. On the other hand, the advanced analysis is not limited to buckling design of these structures. This paper demonstrates its application to the design of a simple plane sway portal and a three diminsional non-sway steel building. The results by the advanced analysis and the first-order linear analysis are compared and the technique for practical second-order analysis steel structures is described. It is observed that the use of a straight element by itself cannot model the buckling resistance of columns governed by different buckling curves for hot-rolled and cold-formed sections of various shapes like I, H, hollow etc. Also the curvature of the conventional cubic Hermite element is not varied by the external axial force and thus it cannot simulate the response of a buckling column. Thus its use for second-order analysis is basically unacceptable. A technique for additional checking of beams undergoing lateral-torsional buckling is also suggested making the advanced analysis a complete design tool for conventional steel frames.

Early childhood Australia's Best of Sustainability : Research, Practice and Theory

ECA Best of Sustainability: Research, theory and practice by Elliott, Edwards, Davis and Cutter-MacKenzie collates a range of key articles focussing on sustainability from past editions of the Australasian Journal of Early Childhood and Every Child. Sustainable service operation and promoting children’s responsibility and care for the environment are now part of the National Quality Standards and more importantly, all early childhood services must engage with sustainability in this time of increasing global environmental concerns. The publication documents the best of research, theory and practice to date and questions where has early childhood education for sustainability come from and more importantly, where is it going? There are multiple possibilities for educators, researchers, policy makers and managers to take action in early childhood settings for an environmentally sustainable future.

Do look now : re-imagining and re-purposing audiovisual creative practice

The appropriation and elaborate re-working of mediated images and sound stand in a fluid relationship with established notions such as creativity, originality and artistic freedom. The evocative, recontextualised montage works of the eminent video artists Christian Marclay (The Clock) and Tracey Moffatt (Other; Love) may be viewed critically in the light of several theorists’ work, such as Walter Benjamin’s ideas on the crisis of reproduction and reactivation. The ironic pastiche, Do Look Now, a recent video installation work, is presented here as a similar dialogical intervention, representing a subversive deconstruction and critique of filmic codes and conventions, as well as being a new work crafted out of old film clips. (The films quoted in the work are listed here in an Appendix). These practical provocations are framed within a renewed, ‘queering’ investigation of creative works. Such an exploration is, arguably, both illuminating and liberating for particular practitioners and researchers engaged with the unpredictable intersections of creative meaning-making in a heavily legalised, mediated and digitised world.

Implications of comorbidity for clinical practice

In the past, people with comorbidity have often received inadequate care. The ethical principle of equal access to quality services has important implications for agencies, when combined with knowledge about comorbidity and its management, and about diffusion of innovations across organizations. Comorbidity is common, and often has profound impacts on individuals and families. Tobacco smoking in particular is endemic and affects morbidity, mortality, and functioning. This implies that screening for co-occurring problems should be routine, and that a boutique comorbidity service is impractical. Large numbers mean that universal screening and intervention must be capable of large-scale implementation. Since multiple, closely linked problems are often present, treatments should address these multiple issues, and closely interrelated problems will require well-integrated treatment. Involvement of a single health agency is typically needed. Numbers and severity of problems can blind practitioners and patients to strengths and unaffected areas; these should be assessed and fostered. Better policies and practices for co-occurring disorders will require organizational change. Co-occurring disorders must become core business for organizations and practitioners, so that effective comorbidity practice is rewarded, required skills are present or taught, cues to use the practices are provided, and a culture supporting their application is established.

Can Business Continuity Management Create Reliability in Airports? (Issues from Theory into Practice)

The advances made within the aviation industry over the past several decades have significantly improved the availability, affordability and convenience of air travel and have been greatly beneficial in both social and economic terms. Air transport has developed into an irreplaceable service being relied on by millions of people each day and as such airports have become critical elements of national infrastructure to facilitate the movement of people and goods. As components of critical infrastructure (CI), airports are integral parts of a national economy supporting regional as well as national trade, commercial activity and employment. Therefore, any disruption or crisis which impacts the continuity of operations at airports can have significant negative consequences for the airport as a business, for the local economy and other nodes of transport infrastructure as well as for society. Due to the highly dynamic and volatile environment in which airports operate in, the aviation industry has faced many different challenges over the years ranging from terrorist attacks such as September 11, to health crises such as the SARS epidemic to system breakdowns such as the recent computer system outage at Virgin Blue Airlines in Australia. All these events have highlighted the vulnerability of airport systems to a range of disturbances as well as the gravity and widespread impact of any kind of discontinuity in airport functions. Such incidents thus emphasise the need for increasing resilience and reliability of airports and ensuring business continuity in the event of a crisis...

Did you see that? Dissociating advanced visual information and ball flight constrains perception and action processes during one-handed catching

The integration of separate, yet complimentary, cortical pathways appears to play a role in visual perception and action when intercepting objects. The ventral system is responsible for object recognition and identification, while the dorsal system facilitates continuous regulation of action. This dual-system model implies that empirically manipulating different visual information sources during performance of an interceptive action might lead to the emergence of distinct gaze and movement pattern profiles. To test this idea, we recorded hand kinematics and eye movements of participants as they attempted to catch balls projected from a novel apparatus that synchronised or de-synchronised accompanying video images of a throwing action and ball trajectory. Results revealed that ball catching performance was less successful when patterns of hand movements and gaze behaviours were constrained by the absence of advanced perceptual information from the thrower's actions. Under these task constraints, participants began tracking the ball later, followed less of its trajectory, and adapted their actions by initiating movements later and moving the hand faster. There were no performance differences when the throwing action image and ball speed were synchronised or de-synchronised since hand movements were closely linked to information from ball trajectory. Results are interpreted relative to the two-visual system hypothesis, demonstrating that accurate interception requires integration of advanced visual information from kinematics of the throwing action and from ball flight trajectory.

The impact on clinical practice of a postgraduate clinical pharmacy programme, incorporating competency-based performance evaluation

Background A goal of the postgraduate clinical pharmacy programme (PGCPP) at the University of Queensland is to enhance clinical practice. Aims To evaluate student perceptions of the impact of the PGCPP on practice and the inclusion of a competency-based performance evaluation as a formative component of the curriculum. Method In 2010, students completed a questionnaire to evaluate the impact of the PGCPP. In 2011, formative competency-based performance evaluations were conducted as a component of the course and the questionnaire was repeated. Responses, competency ratings and evaluation feedback were collated. Data were analysed using descriptive statistics. Results 51/57 (89%) of students completed the questionnaire in 2010 and 2011. Over 90% of students agreed or strongly agreed that the PGCPP enhanced practice, knowledge, confidence and contribution to patient care. Responses were similarly positive after the inclusion of the performance evaluation. Conclusion This study demonstrated that the PGCPP is achieving the goal of enhancing the practice of pharmacists.

Meta-analysis of individual patient data from randomized trials of chemotherapy plus cetuximab as first-line treatment for advanced non-small cell lung cancer

OBJECTIVES: Four randomized phase II/III trials investigated the addition of cetuximab to platinum-based, first-line chemotherapy in patients with advanced non-small cell lung cancer (NSCLC). A meta-analysis was performed to examine the benefit/risk ratio for the addition of cetuximab to chemotherapy. MATERIALS AND METHODS: The meta-analysis included individual patient efficacy data from 2018 patients and individual patient safety data from 1970 patients comprising respectively the combined intention-to-treat and safety populations of the four trials. The effect of adding cetuximab to chemotherapy was measured by hazard ratios (HRs) obtained using a Cox proportional hazards model and odds ratios calculated by logistic regression. Survival rates at 1 year were calculated. All applied models were stratified by trial. Tests on heterogeneity of treatment effects across the trials and sensitivity analyses were performed for all endpoints. RESULTS: The meta-analysis demonstrated that the addition of cetuximab to chemotherapy significantly improved overall survival (HR 0.88, p=0.009, median 10.3 vs 9.4 months), progression-free survival (HR 0.90, p=0.045, median 4.7 vs 4.5 months) and response (odds ratio 1.46, p<0.001, overall response rate 32.2% vs 24.4%) compared with chemotherapy alone. The safety profile of chemotherapy plus cetuximab in the meta-analysis population was confirmed as manageable. Neither trials nor patient subgroups defined by key baseline characteristics showed significant heterogeneity for any endpoint. CONCLUSION: The addition of cetuximab to platinum-based, first-line chemotherapy for advanced NSCLC significantly improved outcome for all efficacy endpoints with an acceptable safety profile, indicating a favorable benefit/risk ratio.