Do high-risk medicines alerts influence practice?

Background: Medicine-related adverse events are prevalent, costly and mostly preventable. The High Risk Medicines Working Party (Victoria) developed and distributed three highrisk medicines alerts – wrong route of administration of oral medicines, subcutaneous insulin and unfractionated heparin – and accompanying audit tools in 2008 and 2009.
Aims: To determine the impact of the three high-risk medicines alerts on Victorian health services; to assess the clinical relevance and utility of the audit tools; to identify barriers to implementing recommendations; and to obtain feedback and suggestions for future alert topics.
Method: A cross-sectional survey was undertaken from 6 to 31 July 2009 using an online questionnaire. The questionnaire was distributed to 90 metropolitan, regional and rural public health services in Victoria and approximately 200 members of the Quality Use of Medicines Network (Victoria).
Results: Most of the 90 respondents were pharmacists (53%) and nurses (31%). 53 (59%) respondents reported making changes as a result of receiving the high-risk medicines alerts – 21 (40%) concerned the wrong route of administration, 12 (23%) subcutaneous insulin and 7 (13%) unfractionated heparin. Barriers to implementation included time constraints, inadequate staff and resources, excessive paperwork and competing priorities. A minority of respondents indicated some alerts were not relevant to small rural services. Suggestions for
improving the audit tools included making them less labour intensive, enabling electronic responses and ensuring their distribution is coordinated with other medicine-related tools.
Conclusion: High-risk medicines alerts and the accompanying audit tools facilitated change but there were some barriers to their implementation, such as time and resource constraints. Not all alerts and audit tools were relevant to all health services.

Industrial biotechnology for the production of proteins/enzymes for a sustainable future

Worldwide emergence of Industrial biotechnology (IB) is providing opportunities to produce enzymes/proteins with variety of industrial/therapeutic applications. In transitioning the Australian economy towards a sustainable future, Federal government identified the development of IB pathway which would ensure increased productivity, enhanced sustainability, health, safety and reduced environmental footprint. The presentation will revolve around specific stories that drives Deakin University newest technology platform which applies biology and fermentation in an integrated way to play a crucial role in developing cost-effective technologies for the development of molecules that can benefit pharmaceutical and food industry in regional Victoria and Australia in general. The talk will also highlight specific examples where new products like recombinant rhamnosidase (an enzyme used for the production of flavonoids with health benefits) and ribosome inactivating proteins (detected in medicinal plants which possess RNA N- glycosidase activity that depurinates the major rRNA, thus damaging ribosome in an irreversible manner and arresting protein synthesis) would be made available through bioprocessing.

The anthropomorphization of Ada Cross

The Anthropomorphization of Ada Cross is an original play and musical composition that is funded by Regional Arts Victoria and its first performance is at West Gippsland Arts Centre as part of the "Backstage Theatre Chamber Season" and the "Be Inspired Gippsland Arts Festival 2011".

When is collaboration not collaboration? When it's militarized

In adopting the medical lobby’s preferred definition of collaboration where midwives are legally compelled to seek endorsement for their care plan from an obstetrician, Determination 2010 connotes a form of militarized collaboration and thus negates all that genuine collaboration stands for–—equality, mutual trust and reciprocal respect. Using Critical Discourse Analysis, the first half of this paper analyses the submissions from medical, midwifery and consumer peak organisations to the Maternity Services Review and Senate reviews held between 2008 and 2010 showing that Determination 2010 privileges the medical lobby worldview in adopting a vertical definition of collaboration. The second half of the paper responds to the principal assumption of Determination 2010–—that midwives do not voluntarily collaborate. It argues by reference to a qualitative inquiry conducted into select caseload maternity units in South Australia, Victoria and New South Wales during 2009—2010 that this presupposition is erroneous. The evidence shows that genuine collaboration is possible without legislative force but it requires a coalition of the willing among senior midwives and obstetricians to institute regular interdisciplinary meetings and clinical reviews and to model respectful behaviour to new entrants.

Greater Green Triangle Risk Factor Study

Very limited data exist for chronic diseases and their risk factors and behaviours in the Greater Green Triangle (GGT) region, or anywhere in rural Australia. To identify health problems and to target interventions and monitor their impact it is necessary to have objective data on chronic disease risk factors. Three cross-sectional surveys were carried out in 2004, 2005 and 2006 in the GGT region in the south east of Australia. In 2004 the survey area was the Limestone Coast in South Australia, 2005 the Corangamite Shire in the south west of Victoria, and in 2006 the Wimmera district in central western Victoria. The data comprises physical measurements and results of blood samples that were taken from patients by specially trained survey nurses. It also comprises data extracted from follow up survey questionnaires that were sent to each patient who returned them through the mail.

Long distancespan galleries

'Long distance' showcases 14 artists who choose to live in country victoria and use their local environment for inspiration

Measuring postgraduates’ research experiences in an Australian university

This article reviews two instruments which have been used to measure postgraduates’ research experiences in an Australian university; (1) the UK Postgraduate Research Experience Survey (PRES); and (2) the Australian Postgraduate Research Experience Questionnaire (PREQ). A comparative study of PRES and PREQ at an Australian university was carried out in 2011. The data collected by the university using PREQ were used as a reference base to compare the validity of the PRES data gathered by the researchers. The results were then benchmarked against the state of Victoria and Australian national standards.

Opening

Opening, a collaboration between Paul Carter, Dirk de Bruyn and Soo Yeun You, combines the Nearamnew artwork etched in the bed of Fed Square’s river of cobblestones with the oral histories and creative research expressed in Ground Truthing.

Opening brings together single frame and time lapse techniques, real-time footage, environmental recordings and choreography in a 37-minute creative manifestation.

This is a unique and special project which brings to life the history, land, design and community of Fed Square. It will transport you through the curving path that spirals out to Lake Tyrrell in Northern Victoria and whirls back to Fed Square.

Provocation in New South Wales : the need for abolition

Over the past two decades significant debate has emerged surrounding the operation of the partial defence of provocation. Such debates have led to its abolition in several Australian and international jurisdictions where Government and Law Commission bodies have argued that provocation has operated in a gender biased way that is no longer reflective of community values and expectations of justice. In contrast to the Australian states of Tasmania, Victoria and Western Australia, who have transferred consideration of provocation to sentencing, New South Wales (NSW) has retained provocation as a partial defence to murder. Drawing upon in-depth interviews conducted with legal stakeholders and an analysis of recent case law, this article considers whether the operation of provocation in NSW is still in the best interests of justice, and, specifically, whether in practice it privileges one gender above the other. This research concludes that the continued operation of provocation in NSW raises key issues surrounding the legitimisation of male violence against women, the denial and minimisation of the harm caused by lethal domestic violence, and the continued inability of the law to appropriately respond to women who kill in the context of prolonged family violence.

Marine protected areas of the Otway bioregion

Along Victoria’s coastline there are 30 Marine Protected Areas (MPAs) that have been established to protect the state’s significant marine environmental and cultural values. These MPAs include 13 Marine National Parks (MNPs), 11 Marine Sanctuaries (MSs), 3 Marine and Coastal Parks, 2 Marine Parks, and a Marine Reserve, and together these account for 11.7% of the Victorian marine environment. The highly protected Marine National Park System, which is made up of the MNPs and MSs, covers 5.3% of Victorian waters and was proclaimed in November 2002. This system has been designed to be representative of the diversity of Victoria’s marine environment and aims to conserve and protect ecological processes, habitats, and associated flora and fauna. The Marine National Park System is spread across Victoria’s five marine bioregions with multiple MNPs and MSs in each bioregion, with the exception of Flinders bioregion which has one MNP. All MNPs and MSs are “no-take” areas and are managed under the National Parks Act (1975) - Schedules 7 and 8 respectively.

This report updates the first Marine Natural Values Study (Plummer et al. 2003) for the MPAs in the Otway bioregion on the west coast of Victoria and is one of a series of five reports covering Victoria’s Marine National Park System. It uses the numerous monitoring and research programs that have increased our knowledge since declaration and aims to give a comprehensive overview of the important natural values of each MNP and MS.

A randomised, feasibility trial of a tele-health intervention for acute coronary syndrome patients with depression (‘MoodCare’): study protocol

Background Coronary heart disease (CHD) and depression are leading causes of disease burden globally and the two often co-exist. Depression is common after Myocardial Infarction (MI) and it has been estimated that 15-35% of patients experience depressive symptoms. Co-morbid depression can impair health related quality of life (HRQOL), decrease medication adherence and appropriate utilisation of health services, lead to increased morbidity and suicide risk, and is associated with poorer CHD risk factor profiles and reduced survival. We aim to determine the feasibility of conducting a randomised, multi-centre trial designed to compare a tele-health program (MoodCare) for depression and CHD secondary prevention, with Usual Care (UC).

Methods Over 1600 patients admitted after index admission for Acute Coronary Syndrome (ACS) are being screened for depression at six metropolitan hospitals in the Australian states of Victoria and Queensland. Consenting participants are then contacted at two weeks post-discharge for baseline assessment. One hundred eligible participants are to be randomised to an intervention or a usual medical care control group (50 per group). The intervention consists of up to 10 × 30-40 minute structured telephone sessions, delivered by registered psychologists, commencing within two weeks of baseline screening. The intervention focuses on depression management, lifestyle factors (physical activity, healthy eating, smoking cessation, alcohol intake), medication adherence and managing co-morbidities. Data collection occurs at baseline (Time 1), 6 months (post-intervention) (Time 2), 12 months (Time 3) and 24 months follow-up for longer term effects (Time 4). We are comparing depression (Cardiac Depression Scale [CDS]) and HRQOL (Short Form-12 [SF-12]) scores between treatment and UC groups, assessing the feasibility of the program through patient acceptability and exploring long term maintenance effects. A cost-effectiveness analysis of the costs and outcomes for patients in the intervention and control groups is being conducted from the perspective of health care costs to the government.

Discussion This manuscript presents the protocol for a randomised, multi-centre trial to evaluate the feasibility of a tele-based depression management and CHD secondary prevention program for ACS patients. The results of this trial will provide valuable new information about potential psychological and wellbeing benefits, cost-effectiveness and acceptability of an innovative tele-based depression management and secondary prevention program for CHD patients experiencing depression.

Sustaining modified behaviours learnt in a diabetes prevention program in regional Australia : the role of social context

Background
The Greater Green Triangle diabetes prevention program was conducted in primary health care setting of Victoria and South Australia in 2004--2006. This program demonstrated significant reductions in diabetes risk factors which were largely sustained at 18 month follow-up. The theoretical model utilised in this program achieved its outcomes through improvements in coping self-efficacy and planning. Previous evaluations have concentrated on the behavioural components of the intervention. Other variables external to the main research design may have contributed to the success factors but have yet to be identified. The objective of this evaluation was to identify the extent to which participants in a diabetes prevention program sustained lifestyle changes several years after completing the program and to identify contextual factors that contributed to sustaining changes.

Methods
A qualitative evaluation was conducted. Five focus groups were held with people who had completed a diabetes prevention program, several years later to assess the degree to which they had sustained program strategies and to identify contributing factors.

Results
Participants value the recruitment strategy. Involvement in their own risk assessment was a strong motivator. Learning new skills gave participants a sense of empowerment. Receiving regular pathology reports was a means of self-assessment and a motivator to continue. Strong family and community support contributed to personal motivation and sustained practice.

Conclusions
Family and local community supports constitute the contextual variables reported to contribute to sustained motivation after the program was completed. Behaviour modification programs can incorporate strategies to ensure these factors are recognised and if necessary, strengthened at the local level.

CADET - Centre for Advanced Design in Engineering Training

BACKGROUND : The Centre for Advanced Design in Engineering Training (CADET) is a partnership of Deakin University and the Gordon Institute of TAFE that will improve access and pathways into careers to address Australia’s critical engineering skills shortage (Walton, C). Local high schools, Belmont High and Matthew Flinders Girls Secondary College are included as strategic partners. CADET is proposed to be a teaching and learning facility providing a project focused modern engineering approach to students at regional schools and TAFE as well as Deakin’s degree programs. CADET will emphasize engineering design and development through virtual and physical modelling, simulation and prototyping – skills at the heart of the 21st century engineering challenges, and will serve as an attractor to engineering and related professions.

PURPOSE : The purpose of this paper is to present an argument toward the development of a Centre for advanced design in engineering training. CADET is proposed to increase the awareness and attractiveness of engineering as an education and career option, particularly for women, in regional schools, provide under one roof state-of-the-art engineering design, modelling and prototyping facilities, facilitate access and articulation pathways between school, VET and Higher Education, increase the physical capacity to serve student demand in western Victoria, and reinvigorate engineering as an essential component of a skilled regional economy.

DESIGN/METHOD : The evidenced based argument towards the proposed centre for advanced design in engineering training is based on a detailed literature review as well as a research study with industry representatives in engineering design. The learning principles of the model are also investigated and aligned to the proposed centre.

RESULTS : CADET is a change to the way engineering has traditionally been taught. The outcomes of CADET will be to provide a broad range of contemporary/relevant teaching programs, improve the social benefits gained from teaching programs, improve retention rates, advance partnerships that link with rural and regional victoria, and collaborate with local communities to encourage governments to support regional capacity building. Through focus group interviews and open discussions with industry and academia over the past 12 months on the integration of design skills in engineering education, results indicate that the following key skills are essential elements required for a successful project oriented design based learning curriculum are creative & innovative skills, successful industry engagement, and awareness of design skills in early years. Feedback also showed that 80% of the industry representatives are looking to recruit graduates who acquired design-equipped skill and 60% indicated that they want graduates who acquired knowledge through projects.

CONCLUSIONS : CADET projected benefits are significant at the strategic and operational levels. They include access for more women in engineering, facilitates articulation pathways between VET and HE, targeted recognised critical current engineering skills shortage in Australia, improvement of regional access, attractiveness and participation in tertiary education, achievement of a significant improvement in the teaching-research nexus.