Management of sharps in ambulance care : a state-wide survey of paramedic knowledge and reported practice

Paramedics are at high risk of exposure to infectious diseases because they frequently undertake procedures such as the use and disposal of sharps as components of everyday practice. While the literature demonstrates that the management of sharps is problematic across all health disciplines, there is a paucity of research examining sharps management practices in the Australian pre-hospital paramedic context. This study examines knowledge and practices of sharps control among paramedics in Queensland, Australia. A mail survey focusing on infection control knowledge and practices was sent to all clinical personnel of the Queensland Ambulance Service (QAS) (N = 2274). A total of 1258 surveys were returned, a response rate of 55.3%. Participants responded to 12 true/false statements on the management of sharps and three questions about recapping practices. Most respondents were knowledgeable about the correct management of sharps, with a mean of 11.28 (out of 12, SD = 1.32). When gauging reported practices, more than half (59.1%, n = 736) of participants reported recapping a needle, and 38.5% (n = 479) reported never having done so. These results reflect good knowledge of general management of sharps among respondents, but suggest deficits regarding reported practices. The results suggest that a comprehensive ambulance in-service education programme focusing particularly on sharps management is required. The study highlights the need for further research on sharps management practices in the field, identification of barriers to safe sharps practices in pre-hospital settings, and 'best practice' for translating good sharps management knowledge into practice.

The critical competences needed for innovative organizational inter-firm and intra-firm integration

In today's highly challenging business environment, an innovative and systemic approach is imperative to survival and growth. Organisational integration and technological integration, are often seen as a catalyst of change that could lead to significant improvements in organisations. The levels of improvement in inter and intra firm integration should arise from a detailed understanding and development of competences within and between organisations. Preliminary findings suggest that lack of trust across organisational cultures within the firms has a negative influence on the development of the capabilities to integrate and align technological innovations and hinders implementation and the effectiveness of the operations. Additionally, poor communication and conflict effects customer satisfaction. Firms need to transfer the competences that support cooperative integration, developed through interaction with supply chain partners, to their relationship arrangements with other supply chain partners, as these are key to ensuring low operational costs.

Identification of critical input variables for risk-based cost estimates for road maintenance and rehabilitation

An estimation of costs for maintenance and rehabilitation is subject to variation due to the uncertainties of input parameters. This paper presents the results of an analysis to identify input parameters that affect the prediction of variation in road deterioration. Road data obtained from 1688 km of a national highway located in the tropical northeast of Queensland in Australia were used in the analysis. Data were analysed using a probability-based method, the Monte Carlo simulation technique and HDM-4’s roughness prediction model. The results of the analysis indicated that among the input parameters the variability of pavement strength, rut depth, annual equivalent axle load and initial roughness affected the variability of the predicted roughness. The second part of the paper presents an analysis to assess the variation in cost estimates due to the variability of the overall identified critical input parameters.

Construction supply chain economic policy implementation for sectoral change : moving beyond the rhetoric

Construction sector policy makers have the opportunity to create improvements and develop economic, social and environmental sustainability through supply chain economics. The idea of the supply chain concept to improve firm behaviour and industry performance is not new. However there has been limited application and little or no measurement to monitor successful implementation. Often purchasing policies have been developed with sound strategic procurement principles but even these have had limited penetration in to the processes and practices of infrastructure agencies. The research reported in this paper documents an action research study currently being undertaken in the Australian construction sector which aims to explore supply chain economic policy implementation for sectoral change by two government agencies. The theory which informs this study is the emerging area of construction supply chain economics. There are five stages to the project including; demand analysis, chain analysis, government agency organizational audit, supplier strategy and strategic alignment. The overall objective is towards the development of a Supplier Group Strategy Map for two public sector agencies. Two construction subsectors are examined in detail; construction and demolition waste and precast concrete. Both of these subsectors are critical to the economic and environmental sustainability performance of the construction sector and the community as a whole in the particular jurisdictions. The local and state government agencies who are at the core of the case studies rely individually on the performance of these sectors. The study is set within the context of a sound state purchasing policy that has however, had limited application by the two agencies. Partial results of the study are presented and early findings indicate that the standard risk versus expenditure procurement model does not capture the complexities of project, owner and government risk considerations. A new model is proposed in this paper, which incorporates the added dimension of time. The research results have numerous stakeholders; they will hold particular value for those interested in regional construction sector economics, government agencies who develop and implement policy and who have a large construction purchasing imprint and the players involved in the two subsectors. Even though this is a study in Australia it has widespread applicability as previous research indicates that procurement reform is of international significance and policy implementation is problematic.

Critical Literacies in Schools : A Primer

Readers and writers use a variety of modes of inscription – print, oral and multimedia – to understand, analyze, critique and transform their social, cultural and political worlds. Beginning from Freire (1970), ‘critical literacy’ has become a theoretically diverse educational project, drawing from reader response theory, linguistic and grammatical analysis from critical linguistics, feminist, poststructuralist, postcolonial and critical race theory, and cultural and media studies. In the UK, Australia, Canada, South Africa, New Zealand and the US different approaches to critical literacy have been developed in curriculum and schools. These focus on social and cultural analysis and on how print and digital texts and discourses work, with a necessary and delicate tension between classroom emphasis on student and community cultural ‘voice’ and social analysis – and on explicit engagement with the technical features and social uses of written and multimodal texts.

Provoking critical awareness and intersubjectivity through "transformative storytelling"

Theories that inform pedagogical practices have positioned young children as innocent, pre-political and egocentric. This paper draws from an action research study that investigates the impact of “transformative storytelling”, where stories purposefully crafted to counter metanarratives, revealed the impact of human greed with one class of children aged five to six years of age. Derrida’s notion of “cinders” provided a concept for investigating the traces or imprints the language of story left behind, amidst the children’s comments and actions, enabling the possibilities of the history of these “cinders” (that is what informed these comments and actions) to be noticed. Readings of some of the children’s responses suggest that children aged five and six years can engage in political discourse through the provocation of “transformative storytelling”, and that their engagement demonstrated the consideration of others through critical awareness and intersubjectivity. These early readings raise questions regarding curriculum content and pedagogical practices in early years education and the validity of ongoing educational goals that incorporate critical awareness and intersubjectivity to equip students with communitarian strategies to counter the individualistic outlook of neoliberalist societies.

Off-site Manufacture in Australia : Current State and Future Directions

Off-site manufacture (OSM) offers numerous benefits to all parties in the construction process. The uptake of OSM in Australia has, however, been limited. This limited uptake corresponds to similar trends in the UK and US, although the level of OSM there appears to be increasing. This project undertook three workshops — one each in Victoria, Queensland and Western Australia — and 18 interviews with key stakeholders to assist in identifying the general benefits and barriers to OSM uptake in the Australian construction industry. Seven case studies were also undertaken, involving construction projects that used OSM, ranging from civil projects through to residential. Each of these case studies has been analysed to identify what worked and what didn’t, and suggest the lessons to be learned from each project.

The enactment of the New Basics Project in a special school

This study investigates the impact of the New Basics Project on teachers at a special school for students with intellectual impairments. The study is aimed at exploring the complex nature of the work of special educators as they enact the New Basics curriculum with a particular focus on the teachers’ opinions about challenges that arose for their curriculum, pedagogy and assessment practices. Attention is also paid to how the principal’s leadership supported the enactment of the New Basics in respect to what he did and why he used particular strategies. The nine teachers and their principal were involved in a series of in-depth, semi-structured interviews from one of only three special schools in phase one of the New Basics trial in Queensland, Australia. These interviews produced data from the special educators as they were confronted with a new curriculum that challenged their previous teaching practices. The enactment of the New Basics curriculum occurred within the context of a state-sanctioned mandate to provide alternative programs to those offered in mainstream schools, for students with special needs. This thesis explores these teachers' experiences using critical theory as a basis for analyzing their opinions on issues such as the role of the special educator, tensions between old and new curricula, pedagogical and assessment practices, and connections between the at-school learning experiences for intellectually impaired students and the realities of post-school life. The investigation also examines the leadership conduct of the principal in changing times at the school. The findings suggest that the New Basics has played a significant role in providing structures for developing communities of practice amongst teachers; in supporting special educators to focus more on the educational needs of the students (e.g., literacy, numeracy, financial planning) and less on their medical needs (e.g., toileting, feeding, personal hygiene); and supporting school leadership that empowers and listens critically to teachers as essential components of the successful enactment of curriculum reforms like the New Basics.

Application of system dynamics for evaluating truck load regulations in Anhui, China

In the critical situation of prevailing overweight transportation and crag-fast enforcement in Chinese highway networks, this paper develops a methodological framework for truck weight regulation (TWR) evaluation using System Dynamics (SD). Composed of five interrelated subsystems, the framework is able to capture the highway, vehicle and freight variables that influence the effect of TWR and transportation efficiency over time. It specifically describes the development and use of the Truck Weight Regulation Evaluating Model (TWREM) for the highway freight system in Anhui province, China. Three policy alternatives are analyzed: 1) tolerant policy approach, which allows heavy-duty freight activity to continue in its current state, and is shown to lead to nearly catastrophic results; 2) rigid policy approach, which would terminate all heavy-duty freight activities immediately, and is shown to be economically infeasible; and 3) moderate policy approach, which advocates a gradual reduction of heavy-duty freight activities to a moderate state. The simulation results shows that the moderate policy approach is the most appropriate option to solve the social and economic problems arising from the activities of the heavy-duty freight transportation in Anhui. In addition, some suggestions of TWR policy in China are also made in this paper.

Teacher educators embrace philosophy: reflections on a new way of looking at preparing pre-service teachers

Over the last decade in Australia, the role of the teacher has changed. Teachers are now expected to model and foster in their students a wide range of skills such as critical thinking, self-regulated learning, knowledge of self and others and lifelong learning. These changes are having a significant impact on the design of pre-service teacher education programmes, with university educators re-evaluating the teacher training curriculum and embedded pedagogical processes in order to consider how they might develop these skills in pre-service teachers. One approach is to consider the processes and practices inherent in philosophical inquiry. This paper reports on three participants’ reflections of a 12-week philosophy programme that was conducted for teacher educators at Queensland’s University of Technology (QUT) in 2008. The programme was facilitated by teachers from Buranda State School who have been teaching philosophy in their P-7 school for more than ten years. This paper provides insight into teacher educators’ reflections on the philosophy programme and the associated changes and challenges of implementing such a programme in pre-service teacher education degrees.

The critical in Ken

That Kenneth Frampton has had a significant impact on architectural thinking in Australia was recently demonstrated by his visit, which included two well-attended public lectures and a one-day symposium dedicated to his thinking and writing. Billed as part of the Year of the Built Environment celebrations, these were hosted by the New South Wales chapter of the RAIA, the UNSW Faculty of the Built Environment and the Museum of Contemporary Art. Richard Francis-Jones of FJMT coordinated the symposium, which comprised presentations divided into two sessions, entitled - predictably through no doubt with good intentions - 'Theory' and 'Practice', with four academics and four practitioners in each. Frampton sat to the side throughout, and delivered his own response between them,noting his discomfort in seemingly straddling this divide, as an architect first, then writer and academic, later. Predictably, the familiar Critical Regionalism argument was the mainstay of the day, perhaps the easiest to handle and now almost automatic, despite the fact that Frampton noted when questioned that he hasn't talked much about it in the last 10 years.

Tricking up the suburb

The following article arises from the projects submitted for the 2004 Awards fo the Western Australian Chapter of the Australian Institute of Landscape Architects, for which we were judges, together with Craig Burton of CAB Consulting and Natalie palleros of Tierra Design. This article is an attempt to understand some dominant trends that emerged from viewing a range of new suburban developments. Suburban developments dominated the awards and seemed to characterise much of the work being done by landscape architects in the west. It is easy to be critical of contemporary landscape architecture in Perth, as the projects presented were mostly the same in that their scope of design activity was restricted to the decorative rather than the structural. However, as critics, we feel it is important to initate a conversation about what has been presented as the best of the profession, in order to begin to understand the current state of the profession.

Responding to an ageing workforce in an Australian state

Many industrialised nations have changing demographic profiles, as increased longevity and decreased birth rates lead to an ageing population. This presents significant challenges for workforces, as older employees retire and there are insufficient numbers of younger employees to take their place. This leads to skills shortages, and strong competition for those who are available. This paper considers these issues in the context of Queensland, the third largest state of Australia. The Queensland Government is addressing the issues for all industries in the state, primarily through a Skills Plan and an Experience Pays Awareness Strategy. As the largest employer in the state, the Queensland Government has commenced implementing the Experience Pays Awareness Strategy within its own workforce. The approach touches on many facets of HRM. The HRM policy framework and tools are examined for their potential to support increased participation of older employees. A range of issues are addressed for older workers, including their competence and health and safety issues. Issues for managers include addressing myths and subtle discrimination against older workers, as well as managing cross-generational workforce. Other strategies and methods are targeted at cultural factors, such as the expectations of older workers, and the myths and discrimination against older workers. Yet other strategies are aimed at organisational issues such retention of knowledge and succession planning.

Critical opinion : the Docklands Precinct

Every one and their dog has done a Docklands design studio at university if they were educated in Melbourne. And all designers have an opinion on the idea of Docklands and its potential in the future, but few, apart from the Docklands authority themselves, have a handle on what's going on there now and what constitutes its qualities.

Prognosis of bearing failure based on health state estimation

This paper proposes a new prognosis model based on the technique for health state estimation of machines for accurate assessment of the remnant life. For the evaluation of health stages of machines, the Support Vector Machine (SVM) classifier was employed to obtain the probability of each health state. Two case studies involving bearing failures were used to validate the proposed model. Simulated bearing failure data and experimental data from an accelerated bearing test rig were used to train and test the model. The result obtained is very encouraging and shows that the proposed prognostic model produces promising results and has the potential to be used as an estimation tool for machine remnant life prediction.