Investigation of decision making issues in the use of current clinical information systems

Clinical information systems have become important tools in contemporary clinical patient care. However, there is a question of whether the current clinical information systems are able to effectively support clinicians in decision making processes. We conducted a survey to identify some of the decision making issues related to the use of existing clinical information systems. The survey was conducted among the end users of the cardiac surgery unit, quality and safety unit, intensive care unit and clinical costing unit at The Prince Charles Hospital (TPCH). Based on the survey results and reviewed literature, it was identified that support from the current information systems for decision-making is limited. Also, survey results showed that the majority of respondents considered lack in data integration to be one of the major issues followed by other issues such as limited access to various databases, lack of time and lack in efficient reporting and analysis tools. Furthermore, respondents pointed out that data quality is an issue and the three major data quality issues being faced are lack of data completeness, lack in consistency and lack in data accuracy. Conclusion: Current clinical information systems support for the decision-making processes in Cardiac Surgery in this institution is limited and this could be addressed by integrating isolated clinical information systems.

Fertility and infertility : studies in reproductive epidemiology in Australia

Worldwide, there are few large-scale epidemiological studies on infertility. In Australia, population-based research on infertility is limited to a few small-scale studies. Therefore, the prevalence of infertility and unmet need for specialist medical advice and treatment cannot be estimated reliably. Women who have used assisted reproductive technologies (ART) are recorded in treatment registries. However, there are many infertile women who are excluded from these clinical populations because they neither seek advice nor use treatment. The thesis was based on a biopsychosocial model of health and used the methods of reproductive epidemiology to address the lack of national data on the prevalence of infertility in Australia. Firstly, numbers of births and pregnancy losses were investigated in two generations of women participating in the Australian Longitudinal Study on Women’s Health (ALSWH). The ALSWH is a broad-ranging, longitudinal examination of biological, psychological and social factors that impact on women’s health and wellbeing. Women from three age cohorts were randomly sampled from the population using the universal public health insurance (i.e., Medicare) database and ALSWH participants were representative of the female population. However, the studies in the thesis only involved data from two cohorts. The younger cohort were born in 1973-78 and completed up to four mailed surveys between 1996 (when they were aged 18-23 years, n=14247) and 2006 (28-33 years, n=9145). The mid-aged cohort were born in 1946-51 and completed four mailed surveys between 1996 (when they were aged 45-50 years n=13715) and 2004 (53-58 years, n=10905). Compared to other studies that focus on outcomes of single pregnancies, these studies included all pregnancy outcomes by developing comprehensive reproductive histories for each woman. Pregnancy outcomes included birth, miscarriage, stillbirth, termination and ectopic pregnancy. Women in the youngest cohort (born in 1973-78) were only just reaching their peak childbearing years and many (44%) had yet to report their first pregnancy outcome. Women from the mid-aged cohort (born 1946-51) had completed their reproductive lives and 92% were able to report on their lifetime pregnancy outcomes. Pregnancy losses, especially miscarriage, were common for both generations of women. Secondly, the prevalence of infertility, seeking medical advice and using treatment was identified for these two generations of women. For the older generation, the lifetime prevalence of infertility and demand for treatment was investigated in the context of the specialist medical services which became available circa 1980. By this time, however, most of these older women had already been pregnant and completed their families. For women who experienced infertility (11%), their options for advice and treatment were limited and less than half (42%) had used any treatment. More recently for the younger generation of women, who were aged 28-33 years in 2006, specialist advice and treatment were extensively available. Among women who had tried to conceive or had been pregnant (n=5936), 17% had experienced infertility and the majority (72%) were able to access medical advice. However, after seeking advice only half of these infertile women had used treatment with fertility hormones or in vitro fertilisation (IVF). Overall for infertile women aged up to 33 years, only one-third had used these treatments. Thirdly, the barriers to accessing medical advice and using treatment for infertility were identified for women aged less than 34 years. Among a community sample of infertile women aged 28-33 years (ALSWH participants), self-reported depression was found to be a barrier to accessing medical advice. The characteristics of these infertile women in the community who had (n=121) or had not (n=110) used treatment were compared to infertile women aged 27-33 years (n=59) attending four fertility clinics. Compared to infertile women in the community, living in major cities and having private health insurance were associated with early use of treatment for infertility at specialist clinics by women aged <34 years. In contrast to most clinical studies of IVF, the final study reported in the thesis took into account repeated IVF cycles and the impact of women’s individual histories on IVF outcomes. Among 121 infertile women (aged 27-46 years) who had 286 IVF cycles, older age and prolonged use of the oral contraceptive pill were associated with fewer eggs collected. Further, women in particular occupations had lower proportions of eggs fertilised normally than women in other occupational groups. These studies form the first large-scale epidemiological examination of infertility in Australia. The finding that two-thirds of women with infertility had not used treatment indicates that there is an unmet need for specialist treatment in women aged less than 34 years. However, barriers to accessing treatment prevent women using ART at a younger age when there is a higher chance of pregnancy.

Australia at the crossroads : a review of school science practical work

In Australia we are at a crossroad in science education. We have come from a long history of adopting international curricula, through to blending international and Australian developed materials, to the present which is a thoroughly unique Australian curriculum in science. This paper documents Australia’s journey over the past 200 years, as we prepare for the unveiling of our first truly Australian National Curriculum. One of the unique aspects of this curriculum is the emphasis on practical work and inquiry-based learning. This paper identifies seven forms of practical work currently used in Australian schools and the purposes aligned with each form by 138 pre-service and experienced in-service teachers. The paper explores the question “What does the impending national curriculum, with its emphasis on practical inquiry mean to the teachers now, are they ready?” The study suggests that practical work in Australian schools is multifaceted, and the teacher aligned purposes are dependent not only upon the age of the student, but also on the type of practical work being undertaken. It was found that most teachers are not ready to teach using inquiry-based pedagogy and cite lack of content knowledge, behaviour management, and lack of physical resources and availability of classroom space as key issues which will hinder their implementation of the inquiry component of Australia’s pending curriculum in science.

Faculty mentoring, evidence-based assessment, and student learning : an Australian exploration of American initiatives

There have been many improvements in Australian engineering education since the 1990s. However, given the recent drive for assuring the achievement of identified academic standards, more progress needs to be made, particularly in the area of evidence-based assessment. This paper reports on initiatives gathered from the literature and engineering academics in the USA, through an Australian National Teaching Fellowship program. The program aims to establish a process to help academics in designing and implementing evidence-based assessments that meet the needs of not only students and the staff that teach them, but also industry as well as accreditation bodies. The paper also examines the kinds and levels of support necessary for engineering academics, especially early career ones, to help meet the expectations of the current drive for assured quality and standards of both research and teaching. Academics are experiencing competing demands on their time and energy with very high expectations in research performance and increased teaching responsibilities, although many are researchers who have not had much pedagogic training. Based on the literature and investigation of relevant initiatives in the USA, we conducted interviews with several identified experts and change agents who have wrought effective academic cultural change within their institutions and beyond. These reveal that assuring the standards and quality of student learning outcomes through evidence-based assessments cannot be appropriately addressed without also addressing the issue of pedagogic training for academic staff. To be sustainable, such training needs to be complemented by a culture of on-going mentoring support from senior academics, formalised through the university administration, so that mentors are afforded resources, time, and appropriate recognition.

Electoral behaviour in the 2010 Australian federal election

All elections are unique, but the Australian federal election of 2010 was unusual for many reasons. It came in the wake of the unprecedented ousting of the Prime Minister who had led the Australian Labor Party to a landslide victory, after eleven years in opposition, at the previous election in 2007. In a move that to many would have been unthinkable, Kevin Rudd’s increasing unpopularity within his own parliamentary party finally took its toll and in late June he was replaced by his deputy, Julia Gillard. Thus the second unusual feature of the election was that it was contested by Australia’s first female prime minister. The third unusual feature was that the election almost saw a first-term government, with a comfortable majority, defeated. Instead it resulted in a hung parliament, for the first time since 1940, and Labor scraped back into power as a minority government, supported by three independents and the first member of the Australian Greens ever to be elected to the House of Representatives. The Coalition Liberal and National opposition parties themselves had a leader of only eight months standing, Tony Abbott, whose ascension to the position had surprised more than a few. This was the context for an investigation of voting behaviour in the 2010 election....

Extending and validating the is-impact model in Saudi Arabia : accounting for computer network quality

Organizations from every industry sector seek to enhance their business performance and competitiveness through the deployment of contemporary information systems (IS), such as Enterprise Systems (ERP). Investments in ERP are complex and costly, attracting scrutiny and pressure to justify their cost. Thus, IS researchers highlight the need for systematic evaluation of information system success, or impact, which has resulted in the introduction of varied models for evaluating information systems. One of these systematic measurement approaches is the IS-Impact Model introduced by a team of researchers at Queensland University of technology (QUT) (Gable, Sedera, & Chan, 2008). The IS-Impact Model is conceptualized as a formative, multidimensional index that consists of four dimensions. Gable et al. (2008) define IS-Impact as "a measure at a point in time, of the stream of net benefits from the IS, to date and anticipated, as perceived by all key-user-groups" (p.381). The IT Evaluation Research Program (ITE-Program) at QUT has grown the IS-Impact Research Track with the central goal of conducting further studies to enhance and extend the IS-Impact Model. The overall goal of the IS-Impact research track at QUT is "to develop the most widely employed model for benchmarking information systems in organizations for the joint benefit of both research and practice" (Gable, 2009). In order to achieve that, the IS-Impact research track advocates programmatic research having the principles of tenacity, holism, and generalizability through extension research strategies. This study was conducted within the IS-Impact Research Track, to further generalize the IS-Impact Model by extending it to the Saudi Arabian context. According to Hofsted (2012), the national culture of Saudi Arabia is significantly different from the Australian national culture making the Saudi Arabian culture an interesting context for testing the external validity of the IS-Impact Model. The study re-visits the IS-Impact Model from the ground up. Rather than assume the existing instrument is valid in the new context, or simply assess its validity through quantitative data collection, the study takes a qualitative, inductive approach to re-assessing the necessity and completeness of existing dimensions and measures. This is done in two phases: Exploratory Phase and Confirmatory Phase. The exploratory phase addresses the first research question of the study "Is the IS-Impact Model complete and able to capture the impact of information systems in Saudi Arabian Organization?". The content analysis, used to analyze the Identification Survey data, indicated that 2 of the 37 measures of the IS-Impact Model are not applicable for the Saudi Arabian Context. Moreover, no new measures or dimensions were identified, evidencing the completeness and content validity of the IS-Impact Model. In addition, the Identification Survey data suggested several concepts related to IS-Impact, the most prominent of which was "Computer Network Quality" (CNQ). The literature supported the existence of a theoretical link between IS-Impact and CNQ (CNQ is viewed as an antecedent of IS-Impact). With the primary goal of validating the IS-Impact model within its extended nomological network, CNQ was introduced to the research model. The Confirmatory Phase addresses the second research question of the study "Is the Extended IS-Impact Model Valid as a Hierarchical Multidimensional Formative Measurement Model?". The objective of the Confirmatory Phase was to test the validity of IS-Impact Model and CNQ Model. To achieve that, IS-Impact, CNQ, and IS-Satisfaction were operationalized in a survey instrument, and then the research model was assessed by employing the Partial Least Squares (PLS) approach. The CNQ model was validated as a formative model. Similarly, the IS-Impact Model was validated as a hierarchical multidimensional formative construct. However, the analysis indicated that one of the IS-Impact Model indicators was insignificant and can be removed from the model. Thus, the resulting Extended IS-Impact Model consists of 4 dimensions and 34 measures. Finally, the structural model was also assessed against two aspects: explanatory and predictive power. The analysis revealed that the path coefficient between CNQ and IS-Impact is significant with t-value= (4.826) and relatively strong with â = (0.426) with CNQ explaining 18% of the variance in IS-Impact. These results supported the hypothesis that CNQ is antecedent of IS-Impact. The study demonstrates that the quality of Computer Network affects the quality of the Enterprise System (ERP) and consequently the impacts of the system. Therefore, practitioners should pay attention to the Computer Network quality. Similarly, the path coefficient between IS-Impact and IS-Satisfaction was significant t-value = (17.79) and strong â = (0.744), with IS-Impact alone explaining 55% of the variance in Satisfaction, consistent with results of the original IS-Impact study (Gable et al., 2008). The research contributions include: (a) supporting the completeness and validity of IS-Impact Model as a Hierarchical Multi-dimensional Formative Measurement Model in the Saudi Arabian context, (b) operationalizing Computer Network Quality as conceptualized in the ITU-T Recommendation E.800 (ITU-T, 1993), (c) validating CNQ as a formative measurement model and as an antecedent of IS Impact, and (d) conceptualizing and validating IS-Satisfaction as a reflective measurement model and as an immediate consequence of IS Impact. The CNQ model provides a framework to perceptually measure Computer Network Quality from multiple perspectives. The CNQ model features an easy-to-understand, easy-to-use, and economical survey instrument.

Starter packs : a good start to therapy?

Samples of drugs are often given to doctors by pharmaceutical representatives as part of a marketing strategy. Despite the well described advantages of drug samples, little has been published on the potential adverse outcomes. A series of consumer calls to the Adverse Medicine Events Line has highlighted concerns regarding the quality use of medicines associated with drug samples. The most commonly reported problems were drug samples being supplied to patients with inadequate information regarding dosage, administration, storage and possible adverse effects. In addition, some patients were given excessive quantities of a drug. To reduce such adverse outcomes, the drug industry, health professionals and consumers should be aware of the potential problems associated with starter packs.

Goodbye TAIS and thanks for all the information

The Therapeutic Advice and Information Service was funded by the National Prescribing Service to provide a national drug information service for health professionals working in the community. For ten years the service achieved high levels of client satisfaction, and reached its contracted target of 6000 enquiries about medicines per year, however the service ceased on 30 June 2010.

National architecture conference 2012

May was a particularly busy month with lots of exciting architectural things happening in Brisbane, including the sell-out 2012 National Architecture Conference. The total number of conference attendees was 1,625, which was the largest number of attendees to any Australian National Architecture Conference to date. This was the first time that the National Architecture Conference had been held in Brisbane in over 20 years, and the enormous turnout of 947 Queenslanders to the conference was testament to the positive decision to include Brisbane as a conference venue. The theme of this year’s conference was ‘experience’. Building on ideas introduced in the recent ‘natural artifice’ conference, creative directors Shane Thompson, Michael Rayner and Peter Skinner focused closely on the real, sensed experience of architecture within its natural and constructed settings and the experience of designing and making architecture. The conference attracted a variety of high profile international speakers, including architect and professor, Wang Shu, the 2012 Pritzker Architecture Prize Laureate and co-founder of the Amateur Architecture Studio in China. Other highlights included presentations from Peter Rich [South Africa], Kathryn Findlay [United Kingdom], Rachel Neeson [Australia], Anuradha Mathur & Dilip da Cunha [United States] and Kjetil Thorsen [Norway]. QUT had a strong presence at the conference. In addition to pleasing attendance rates from QUT School of Design students and staff, our Head-of-School Professor Paul Sanders, was given the honourable task of introducing keynote speaker Peter Rich, and facilitating the Q&A session after his presentation, which received a standing ovation. There were many events organised for students and young architects by QUT’s SONA reps, including a masterclass, opening party, collaborative design and construction of the SONA Pavilion, and finally, organisation of the all important SONA Hangover Breakfast, the morning after the closing party. The 2012 National Architecture Conference was truly memorable and an experience not to have been missed. I encourage anyone with a passion for architecture and a desire to be completely inspired by current and emerging leaders in our exciting profession, to start making plans to attend next year’s conference.

Alter/Asians : Asian-Australian Identities in Art, Media and Popular Culture

Exploration of how Australia and Asia are intertwined in everyday culture, and in the imagined worlds of Australians of all backgrounds. Investigates Asian cultural production of art, literature, media and performance that embody Asian social and cultural experiences. Includes endnotes, bibliography and index. Ang and Chalmers work in the School of Cultural Studies at University of Western Sydney. Law and Thomas are Australian Research Council Postdoctoral Fellows at Australian National University and the Research Centre in Inter-communal Studies respectively.

eHealth in Australia and elsewhere : a comparison and lessons for the near future

Meticulous planning and preparation do not always guarantee that eHealth programs unfold as predicted. eHealth entails interdependent social interactions which are difficult to predict without past experience or reference to lessons learned. Judicious insight into past case studies and eventualities, therefore, is essential towards building a successful eHealth solution. Australia’s eHealth program is at a crucial stage where appropriate policy considerations and operational changes are in order. In this paper, we present an initial exploration of prominent eHealth initiatives of other countries to identify similarities, differences and to seek lessons towards making Australia’s eHealth initiative a better journey.

Labor market reform and the changing structure of wage determination in China's state sector during the 1980s

China's market-oriented labor market reform has been in place for about one and a half decades. This study uses individual data for 1981 and 1987 to examine the success of the first half of the reform program. Success is evaluated by examining changes in the wage setting structure in the state-owned sector over the reform period. Have the market reforms stimulated worker incentives by increasing the returns to human capital acquisition? Has the wage structure altered to more closely mimic that of a market economy? In 1987, there is evidence of a structural change in the system of wage determination, with slightly increased rates of return to human capital. However, changes in industrial wage differentials appear to play the dominant role. It is argued that this may be due to labor market reforms, in particular the introduction of the profit related bonus scheme.J. Comp. Econom.,December 1997,25(3), pp. 403–421. Australian National University, Canberra, ACT0200, Australia and University of Tasmania, Hobart, Tasmania, Australia, and University of Aberdeen, Old Aberdeen, Scotland AB24 3QY.

Aliens, borders and social citizens : Health and community services for trafficked women

Australian policy makers recognise women who are trafficked to Australia (and these are largely for the purposes of sexual exploitation) primarily as victims of crime. The main public mechanism by which the "problem" of trafficked people in Australia is managed is the criminal law. At the same time, however, as a signatory to the UN Protocol on Trafficking and the Declaration of Human Rights, the Australian Government also recognises the rights of women trafficked to Australia to access health and community services in the wake of the health damage and trauma they often incur as a consequence of their experience. Current evidence suggests that trafficked women in Australia face considerable barriers in being able to avail themselves of such a right and of the services that accompany it. This paper explores the tensions posed by Australian policy and service approaches to trafficked women in light of the concept of social citizenship and the ways in which it is mediated in the Australian context by national border protection policy.

Standing brave in the face of rapid curriculum change : EAL/D teachers speak about critical literacy and its place in senior English teaching

Critical literacy (CL) has been the subject of much debate in the Australian public and education arenas since 2002. Recently, this debate has dissipated as literacy education agendas and attendant policies shift to embrace more hybrid models and approaches to the teaching of senior English. This paper/presentation reports on the views expressed by four teachers of senior English about critical literacy and it’s relevance to students who are from culturally and linguistically diverse backgrounds who are learning English while undertaking senior studies in high school. Teachers’ understandings of critical literacy are important, esp. given the emphasis on Critical and Creative Thinking and Literacy as two of the General Capabilities underpinning the Australian national curriculum. Using critical discourse analysis, data from four specialist ESL teachers in two different schools were analysed for the ways in which these teachers construct critical literacy. While all four teachers indicated significant commitment to critical literacy as an approach to English language teaching, the understandings they articulated varied from providing forms of access to powerful genres, to rationalist approaches to interrogating text, to a type of ‘critical-aesthetic’ analysis of text construction. Implications are also discussed.

Prosecution of maritime terrorists : the role of national courts in ensuring accountability

Maritime security has emerged as a critical legal and political issue in the contemporary world. Terrorism in the maritime domain is a major maritime security issue. Ten out of the 44 major terrorist groups of the world, as identified in the US Department of State’s Country Reports on Terrorism, have maritime terrorism capabilities. Prosecution of maritime terrorists is a politically and legally difficult issue, which may create conflicts of jurisdiction. Prosecution of alleged maritime terrorists is carried out by national courts. There is no international judicial institution for the prosecution of maritime terrorists. International law has therefore anticipated a vital role for national courts in this respect. The international legal framework for combating maritime terrorism has been elaborately examined in existing literature therefore this paper will only highlight the issues regarding the prosecution of maritime terrorists. This paper argues that despite having comprehensive intentional legal framework for the prosecution of maritime terrorists there is still some scopes for conflicts of jurisdiction particularly where two or more States are interested to prosecute the same offender. This existing legal problem has been further aggravated in the post September 11 era. Due to the political and security implications, States may show reluctance in ensuring the international law safeguards of alleged perpetrators in the arrest, detention and prosecution process. Nevertheless, international law has established a comprehensive system for the prosecution of maritime terrorists where national courts is the main forum of ensuring the international law safeguards of alleged perpetrators as well as ensuring the effective prosecution of maritime terrorists thereby playing an instrumental role in establishing a rule based system for combating maritime terrorism. Using two case studies, this paper shows that the role of national courts has become more important in the present era because there may be some situations where no State is interested to initiate proceedings in international forums for vindicating rights of an alleged offender even if there is a clear evidence of violation of international human rights law in the arrest, detention and prosecution process. This paper presents that despite some bottlenecks national courts are actively playing this critical role. Overall, this paper highlights the instrumental role of national courts in the international legal order.