Where have all the workers gone? Exploring public sector workforce planning

Governments undertake extensive planning of many services and functions, but tend to neglect planning of public service workforces. Disruptions to public service delivery, such as shortages of nurses and doctors, have rejuvenated interest in workforce planning, but many organisations struggle to do it effectively. This historical study examines the capacity of central personnel agencies to predict workforce risks and support workforce planning, using a study of the Queensland public service. It identifies lack of workforce data as a barrier to effective workforce planning, as a result of factors such as changes in the direction of the central personnel agency, lack of appreciation for the value of comprehensive central workforce data, and limited agency human resource (HR) skills or capacity.

Withholding and withdrawing life-sustaining medical treatment

• At common law, a competent adult can refuse life-sustaining medical treatment, either contemporaneously or through an advance directive which will operate at a later time when the adult’s capacity is lost. • Legislation in most Australian jurisdictions also provides for a competent adult to complete an advance directive that refuses life-sustaining medical treatment. • At common law, a court exercising its parens patriae jurisdiction can consent to, or authorise, the withdrawal or withholding of life-sustaining medical treatment from an adult or child who lacks capacity if that is in the best interests of the person. A court may also declare that the withholding or withdrawal of treatment is lawful. • Guardianship legislation in most jurisdictions allows a substitute decision-maker, in an appropriate case, to refuse life-sustaining medical treatment for an adult who lacks capacity. • In terms of children, a parent may refuse life-sustaining medical treatment for his or her child if it is in the child’s best interests. • While a refusal of life-sustaining medical treatment by a competent child may be valid, this decision can be overturned by a court. • At common law and generally under guardianship statutes, demand for futile treatment need not be complied with by doctors.

Securing medical research data with a rights management system

We propose a digital rights management approach for sharing electronic health records for research purposes and argue advantages of the approach. We give an outline of our implementation, discuss challenges that we faced and future directions.

Attitudes towards inclusion : gaps between belief and practice

General education teachers in the Republic of Korea were investigated regarding their participation in programs to include students with disabilities in general education settings. Previous studies have shown that even general education teachers with positive attitudes towards inclusion are reluctant in practice to have students with disabilities in their classrooms. This study examines 33 Korean general education teachers from three primary schools in Seoul regarding their attitudes towards, and willingness to accommodate, the needs of a student with a disability. The results show that 41.37% of general education teachers had positive attitudes towards inclusion programs, while 55.16% were unwilling to actually participate. Quantitative data obtained through a questionnaire was supplemented by qualitative data obtained through interviews. The interviews focused on the positive and negative effects of inclusion, as well as problems in implementing inclusive education programs. The findings will be discussed in the light of previous international research and will highlight links between the age and teaching experience of general education teachers and their negative attitudes towards inclusion.

Design of a Web interface for anatomical images

Interactive documents for use with the World Wide Web have been developed for viewing multi-dimensional radiographic and visual images of human anatomy, derived from the Visible Human Project. Emphasis has been placed on user-controlled features and selections. The purpose was to develop an interface which was independent of host operating system and browser software which would allow viewing of information by multiple users. The interfaces were implemented using HyperText Markup Language (HTML) forms, C programming language and Perl scripting language. Images were pre-processed using ANALYZE and stored on a Web server in CompuServe GIF format. Viewing options were included in the document design, such as interactive thresholding and two-dimensional slice direction. The interface is an example of what may be achieved using the World Wide Web. Key applications envisaged for such software include education, research and accessing of information through internal databases and simultaneous sharing of images by remote computers by health personnel for diagnostic purposes.

Birthing practices of traditional birth attendants in south Asia in the context of training programmes

Traditional Birth Attendants (TBA) training has been an important component of public health policy interventions to improve maternal and child health in developing countries since the 1970s. More recently, since the 1990s, the TBA training strategy has been increasingly seen as irrelevant, ineffective or, on the whole, a failure due to evidence that the maternal mortality rate (MMR) in developing countries had not reduced. Although, worldwide data show that, by choice or out of necessity, 47 percent of births in the developing world are assisted by TBAs and/or family members, funding for TBA training has been reduced and moved to providing skilled birth attendants for all births. Any shift in policy needs to be supported by appropriate evidence on TBA roles in providing maternal and infant health care service and effectiveness of the training programmes. This article reviews literature on the characteristics and role of TBAs in South Asia with an emphasis on India. The aim was to assess the contribution of TBAs in providing maternal and infant health care service at different stages of pregnancy and after-delivery and birthing practices adopted in home births. The review of role revealed that apart from TBAs, there are various other people in the community also involved in making decisions about the welfare and health of the birthing mother and new born baby. However, TBAs have changing, localised but nonetheless significant roles in delivery, postnatal and infant care in India. Certain traditional birthing practices such as bathing babies immediately after birth, not weighing babies after birth and not feeding with colostrum are adopted in home births as well as health institutions in India. There is therefore a thin precarious balance between the application of biomedical and traditional knowledge. Customary rituals and perceptions essentially affect practices in home and institutional births and hence training of TBAs need to be implemented in conjunction with community awareness programmes.