Shortfalls in malnutrition coding : a mandate for action

The International Classification of Diseases, Version 10, Australian modification (ICD-10- AM) is commonly used to classify diseases in hospital patients. ICD-10-AM defines malnutrition as “BMI < 18.5 kg/m2 or unintentional weight loss of ≥ 5% with evidence of suboptimal intake resulting in subcutaneous fat loss and/or muscle wasting”. The Australasian Nutrition Care Day Survey (ANCDS) is the most comprehensive survey to evaluate malnutrition prevalence in acute care patients from Australian and New Zealand hospitals1. This study determined if malnourished participants were assigned malnutritionrelated codes as per ICD-10-AM. The ANCDS recruited acute care patients from 56 hospitals. Hospital-based dietitians evaluated participants’ nutritional status using BMI and Subjective Global Assessment (SGA). In keeping with the ICD-10-AM definition, malnutrition was defined as BMI <18.5kg/m2, SGA-B (moderately malnourished) or SGA-C (severely malnourished). After three months, in this prospective cohort study, hospitals’ health information/medical records department provided coding results for malnourished participants. Although malnutrition was prevalent in 32% (n= 993) of the cohort (N= 3122), a significantly small number were coded for malnutrition (n= 162, 16%, p<0.001). In 21 hospitals, none of the malnourished participants were coded. This is the largest study to provide a snapshot of malnutrition-coding in Australian and New Zealand hospitals. Findings highlight gaps in malnutrition documentation and/or subsequent coding, which could potentially result in significant loss of casemix-related revenue for hospitals. Dietitians must lead the way in developing structured processes for malnutrition identification, documentation and coding.

Mandate for remote sensing education and the remote sensing core curriculum

Consensus was developed by the remote sensing community during the 1980s and early 1990s regarding the need for an organized approach to teaching remote sensing fundamentals for collegiate institutions. Growth of the remote sensing industry might be seriously hampered without concerted efforts to bolster the capacity to teach state-of-the-practice remote sensing theory and practice to the next generation of professionals. A concerted effort of educators, researchers, government, and industry began in 1992 to meet these demands leading to the creation of the Remote Sensing Core Curriculum. The RSCC is currently sustained by cooperative efforts of the ASPRS, ICRSE, NASA, NCGIA, and others in the remote sensing community. Growth of the RSCC into the K-12 community resulted from its Internet teaching foundation that enables comprehensive and response reference links to the whole of the education community.

Social justice and high-quality human services : visioning the place of a contemporary professional association

The current world situation is plagued by “wicked problems” and a widespread sense of “things are going to get worse”. We confront the almost imponderable consequences of global habitat destruction and climate change, as well as the meltdown of the financial markets with their largely yet to be seen damage to the “real economy”. These things will have considerable negative impacts on the social system and people's lives, particularly the disadvantaged and socially excluded, and require innovative policy and program responses delivered by caring, intelligent, and committed practitioners. These gargantuan issues put into perspective the difficulties that confront social, welfare, and community work today. Yet, in times of trouble, social work and human services tend to do well. For example, although Australian Social Workers and Welfare and Community Workers have experienced phenomenal job growth over the past 5 years, they also have good prospects for future growth and above average salaries in the seventh and sixth deciles, respectively (Department of Education, Employment and Workplace Relations, 2008). I aim to examine the host of reasons why the pursuit of social justice and high-quality human services is difficult to attain in today's world and then consider how the broadly defined profession of social welfare practitioners may collectively take action to (a) respond in ways that reassert our role in compassionately assisting the downtrodden and (b) reclaim the capacity to be a significant body of professional expertise driving social policy and programs. For too long social work has responded to the wider factors it confronts through a combination of ignoring them, critiquing from a distance, and concentrating on the job at hand and our day-to-day responsibilities. Unfortunately, “holding the line” has proved futile and, little by little, the broad social mandate and role of social welfare has altered until, currently, most social programs entail significant social surveillance of troublesome or dangerous groups, rather than assistance. At times it almost seems like the word “help” has been lost in the political and managerial lexicon, replaced by “manage” and “control”. Our values, beliefs, and ethics are under real threat as guiding principles for social programs.

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.

Mandates: An Australian example at the Queensland University of Technology

This presentation describes a situation where an open access mandate was developed and implemented at an institutional level, in this case, an Australian University. Some conclusions are drawn about its effect over a five year period of implementation.

Clinical significance of Mycobacterium asiaticum isolates in Queensland, Australia

Mycobacterium asiaticum was first reported as a cause of human disease in 1982, with only a few cases in the literature to date. This study aims to review the clinical significance of M. asiaticum isolates in Queensland, Australia. A retrospective review (1989 to 2008) of patients with M. asiaticum isolates was conducted. Data were collected through the Queensland TB Control Centre database. Disease was defined in accordance with the American Thoracic Society criteria. Twenty-four patients (13 female) had a positive culture of M. asiaticum, many residing around the Tropic of Capricorn. M. asiaticum was responsible for pulmonary disease (n = 2), childhood lymphadenitis (n = 1), olecranon bursitis (n = 1), 6 cases of possible pulmonary disease, and 2 possible wound infections. Chronic lung disease was a risk factor for pulmonary infection, and wounds/lacerations were a risk factor for extrapulmonary disease. Extrapulmonary disease responded to local measures. Pulmonary disease responded to ethambutol-isoniazid-rifampin plus pyrazinamide for the first 2 months in one patient, and amikacin-azithromycin-minocycline in another patient. While M. asiaticum is rare in Queensland, there appears to be an environmental niche. Although often a colonizer, it can be a cause of pulmonary and extrapulmonary disease. Treatment of pulmonary disease remains challenging. Extrapulmonary disease does not mandate specific nontuberculous mycobacterium (NTM) treatment.

Unionization : a necessary strategy to arrest professional decline?

This article examines contemporary social work and why it is under serious threat, ideologically and economically, in a rapidly changing world that no longer highly values its social mandate, methods, and outcomes. Within this hostile environment we investigate the low salaries and high student debt that beginning social workers experience, which might otherwise drive them into unions. Instead, the profession resists unionization, preferring to remain focused on its ideals rather than the disquieting marketplace realities. We then examine the general elements of a hybrid union model that can assist social workers to organize and thus arrest their long-standing professional and fiscal decline.

The impact of institutional, instrumental and interpersonal underpinnings on network dynamics and outcomes

Networks form a key part of the infrastructure of contemporary governance arrangements and, as such, are likely to continue for some time. Networks can take many forms and be formed for many reasons. Some networks have been explicitly designed to generate a collective response to an issue; some arise from a top down perspective through mandate or coercion; while others rely more heavily on interpersonal relations and doing the right thing. In this paper, these three different perspectives are referred to as the “3I”s: Instrumental, Institutional or Interpersonal. It is proposed that these underlying motivations will affect the process dynamics within the different types of networks in different ways and therefore influence the type of outcomes achieved. This proposition is tested through a number of case studies. An understanding of these differences will lead to more effective design, management and clearer expectations of what can be achieved through networks.

User-generated content and the future of public broadcasting : a case study of the special broadcasting service

This thesis presents a case study of the Special Broadcasting Service documenting the broadcasting challenges posed by user-generated content initiatives and the work-place approach to strategies for participation. Using the action research method, the project findings reveal that limitations to resources and funding determined the scope for innovation and that the practice of executive editorial control over content was considered fundamental to fulfilling the responsibilities of the public service mandate. Media workers were overwhelmingly positive about the enhanced productive capabilities of the audience and willing to facilitate moderated interactions, however the effectiveness of these initiatives differed according to the level of skills required. This thesis demonstrates how participatory initiatives can enhance aspects of the public service remit relating to cultural diversity, the servicing of niche interests, and broader social representation, and help reinvigorate the relevance of public service broadcasting in the digitalised media sphere.

Establishing content validity of a survey research instrument : the older patients in acute care survey - United States

Geriatric nursing competency in the acute care setting is a social mandate for the 21st century. This article reports on the content validation of an Australian research instrument, the Older Patients in Acute Care Survey (OPACS) that examines the attitudes, the knowledge, and the practices of nurses working with acute care patients. The OPACS tool was developed primarily to assist nurse educators to assess attitudes, knowledge, and practices of nursing staff in caring for older patients in the acute care setting; to evaluate the implementation of institution-specific educational interventions; and to improve quality of care given to older patients. An overall content validity index (CVI) for the OPACS was calculated (CVI = .918), revealing high content validity. Opinions (CVI = .92) and practices (CVI = .97) subconstructs revealed high content validity as well. Therefore, results indicate that the OPACS has high content validity in the U.S. acute care setting and could assist nurse educators in establishing and enhancing nurse competency in the care for geriatric patients in the future.

Energy polarization and popular representation: Evidence from the Russian Duma

In this article we introduce the term “energy polarization” to explain the politics of energy market reform in the Russian Duma. Our model tests the impact of regional energy production, party cohesion and ideology, and electoral mandate on the energy policy decisions of the Duma deputies (oil, gas, and electricity bills and resolution proposals) between 1994 and 2003. We find a strong divide between Single-Member District (SMD) and Proportional Representation (PR) deputies High statistical significance of gas production is demonstrated throughout the three Duma terms and shows Gazprom's key position in the post-Soviet Russian economy. Oil production is variably significant in the two first Dumas, when the main legislative debates on oil privatization occur. There is no constant left–right continuum, which is consistent with the deputies' proclaimed party ideology. The pro- and anti-reform poles observed in our Poole-based single dimensional scale are not necessarily connected with liberal and state-oriented regulatory policies, respectively. Party switching is a solid indicator of Russia's polarized legislative dynamics when it comes to energy sector reform.

Graduate research capabilities : a new agenda for research supervisors

There has been a conversation about university graduate employability within the Higher Education literature for some time (Cryer, 1997; Barrie, 2004, 2006, 2007; Murray, 2000; McAlpine, 2005). Within this, and often under the banner of questioning the relevance of the PhD (Murray, 2000), there have been discussions about the employability of research postgraduates. Both the broad discussion of graduate employment and the specific discussion of research degree graduate employment have produced an agenda of graduate research capabilities. Traditionally, assisting research higher degree (RHD) students with their career development has not been an articulated part of the research supervision process. However, the graduate research capabilities agenda has added a new element to the practices of research supervision, in that it brings with it a mandate for research graduates to be aware of the range of capabilities they have acquired through their research degree candidature and how these apply in the workforce. Additionally, there is an emphasis on preparing students for varied career paths rather than a traditional academic route (e.g., in industry or government). Supervisors have a vital role to play in assisting students with these important career development tasks. In this practice application brief we report on a strategy recently used at Queensland University of Technology (QUT) to assist supervisors understand their role in a student’s career development.

Quality of child abuse information in emergency department injury surveillance data : linking hospital and child welfare data

Emergency departments (EDs) are often the first point of contact with an abused child. Despite legal mandate, the reporting of definite or suspected abusive injury to child safety authorities by ED clinicians varies due to a number of factors including training, access to child safety professionals, departmental culture and a fear of ‘getting it wrong’. This study examined the quality of documentation and coding of child abuse captured by ED based injury surveillance data and ED medical records in the state of Queensland and the concordance of these data with child welfare records. A retrospective medical record review was used to examine the clinical documentation of almost 1000 injured children included in the Queensland Injury Surveillance Unit database (QISU) from 10 hospitals in urban and rural centres. Independent experts re-coded the records based on their review of the notes. A data linkage methodology was then used to link these records with records in the state government’s child welfare database. Cases were sampled from three sub-groups according to the surveillance intent codes: Maltreatment by parent, Undetermined and Unintentional injury. Only 0.1% of cases coded as unintentional injury were recoded to maltreatment by parent, while 1.2% of cases coded as maltreatment by parent were reclassified as unintentional and 5% of cases where the intent was undetermined by the triage nurse were recoded as maltreatment by parent. Quality of documentation varied across type of hospital (tertiary referral centre, children’s, urban, regional and remote). Concordance of health data with child welfare data varied across patient subgroups. Outcomes from this research will guide initiatives to improve the quality of intentional child injury surveillance systems.

QUT Digital Repository: Integrating the University’s IR with other digital collections

Queensland University of Technology’s Institutional Repository, QUT ePrints (http://eprints.qut.edu.au/), was established in 2003. With the help of an institutional mandate (endorsed in 2004) the repository now holds over 11,000 open access publications. The repository’s success is celebrated within the University and acknowledged nationally and internationally. QUT ePrints was built on GNU EPrints open source repository software (currently running v.3.1.3) and was originally configured to accommodate open access versions of the traditional range of research publications (journal articles, conference papers, books, book chapters and working papers). However, in 2009, the repository’s scope, content and systems were broadened and the ‘QUT Digital repository’ is now a service encompassing a range of digital collections, services and systems. For a work to be accepted in to the institutional repository, at least one of the authors/creators must have a current affiliation with QUT. However, the success of QUT ePrints in terms of its capacity to increase the visibility and accessibility of our researchers' scholarly works resulted in requests to accept digital collections of works which were out of scope. To address this need, a number of parallel digital collections have been developed. These collections include, OZcase, a collection of legal research materials and ‘The Sugar Industry Collection’; a digitsed collection of books and articles on sugar cane production and processing. Additionally, the Library has responded to requests from academics for a service to support the publication of new, and existing, peer reviewed open access journals. A project is currently underway to help a group of senior QUT academics publish a new international peer reviewed journal. The QUT Digital Repository website will be a portal for access to a range of resources to support copyright management. It is likely that it will provide an access point for the institution’s data repository. The data repository, provisionally named the ‘QUT Data Commons’, is currently a work-in-progress. The metadata for some QUT datasets will also be harvested by and discoverable via ‘Research Data Australia’, the dataset discovery service managed by the Australian National Data Service (ANDS). QUT Digital repository will integrate a range of technologies and services related to scholarly communication. This paper will discuss the development of the QUT Digital Repository, its strategic functions, the stakeholders involved and lessons learned.

Support for gold open access publishing strategies at QUT

INTRODUCTION: Since the introduction of its QUT ePrints institutional repository of published research outputs, together with the world’s first mandate for author contributions to an institutional repository, Queensland University of Technology (QUT) has been a leader in support of green road open access. With QUT ePrints providing our mechanism for supporting the green road to open access, QUT has since then also continued to expand its secondary open access strategy supporting gold road open access, which is also designed to assist QUT researchers to maximise the accessibility and so impact of their research. ---------- METHODS: QUT Library has adopted the position of selectively supporting true gold road open access publishing by using the Library Resource Allocation budget to pay the author publication fees for QUT authors wishing to publish in the open access journals of a range of publishers including BioMed Central, Public Library of Science and Hindawi. QUT Library has been careful to support only true open access publishers and not those open access publishers with hybrid models which “double dip” by charging authors publication fees and libraries subscription fees for the same journal content. QUT Library has maintained a watch on the growing number of open access journals available from gold road open access publishers and their increased rate of success as measured by publication impact. ---------- RESULTS: This paper reports on the successes and challenges of QUT’s efforts to support true gold road open access publishers and promote these publishing strategy options to researchers at QUT. The number and spread of QUT papers submitted and published in the journals of each publisher is provided. Citation counts for papers and authors are also presented and analysed, with the intention of identifying the benefits to accessibility and research impact for early career and established researchers.---------- CONCLUSIONS: QUT Library is eager to continue and further develop support for this publishing strategy, and makes a number of recommendations to other research institutions, on how they can best achieve success with this strategy.