Using information and communication technologies to consult with patients in Victorian primary care : the views of general practitioners

Information and communication technologies such as email, text messaging and video messaging are commonly used by the general population. However, international research has shown that they are not used routinely by GPs to communicate or consult with patients. Investigating Victorian GPs’ perceptions of doing so is timely given Australia’s new National Broadband Network, which may facilitate web-based modes of doctor-patient interaction. This study therefore aimed to explore Victorian GPs’ experiences of, and attitudes toward, using information and communication technologies to consult with patients. Qualitative telephone interviews were carried out with a maximum variation sample of 36 GPs from across Victoria. GPs reported a range of perspectives on using new consultation technologies within their practice. Common concerns included medico-legal and remuneration issues and perceived patient information technology literacy. Policy makers should incorporate GPs’ perspectives into primary care service delivery planning to promote the effective use of information and communication technologies in improving accessibility and quality of general practice care.

Managing post-discharge care at home: an analysis of patients' and their carers' perceptions of information received during their stay in hospital

This small-scale study carried out in a Melbourne metropolitan hospital explored patients’ and their carers’ perceptions of information, adequacy of information, and their utilization of information concerning post-discharge care received from health professionals during their stay in hospital. The research design consisted of two stages. Stage one involved a qualitative approach using focused interviews of five pairs of patients and their carers, 2 weeks after discharge from hospital. Five main themes emerged from the content analysis of the interview transcripts: information given by health professionals to patients and carers, patients’ and carers’ psychological well-being, activities of daily living, caring tasks of the patients, and community linkages. A quantitative approach was used for stage two involving two sets of questionnaires, one for the patient and one for the carer, developed from the themes identified in stage one. A pilot study was conducted on three pairs of patients and their carers, 2 weeks after discharge from hospital. The main study consisted of a convenience sample of 40 pairs of patients and their carers who completed the questionnaires 2 weeks post-discharge. Data analysis of stage two of the study consisted of descriptive statistics and cross-tabulations. The main findings suggested that carers received very little information from health professionals concerning their patients’ health problems and care at home. The carers’ health and employment states were often not considered in their patients’ discharge plan. Carers who were present with their patients when they received information concerning post-discharge care experienced a decrease in anxiety during their patients’ convalescence at home, greater satisfaction with the information they received, and their patients experienced fewer medical problems post-discharge. The implications for nursing practice and research include recommendations for a more effective system of discharge planning, and further research to include a larger population with a more varied group of participants.

Infant feeding websites and apps: a systematic assessment of quality and content

Background: Internet websites and smartphone apps have become a popular resource to guide parents in their children’s feeding and nutrition. Given the diverse range of websites and apps on infant feeding, the quality of information in these resources should be assessed to identify whether consumers have access to credible and reliable information.

Objective: This systematic analysis provides perspectives on the information available about infant feeding on websites and smartphone apps.

Methods: A systematic analysis was conducted to assess the quality, comprehensibility, suitability, and readability of websites and apps on infant feeding using a developed tool. Google and Bing were used to search for websites from Australia, while the App Store for iOS and Google Play for Android were used to search for apps. Specified key words including baby feeding, breast feeding, formula feeding and introducing solids were used to assess websites and apps addressing feeding advice. Criteria for assessing the accuracy of the content were developed using the Australian Infant Feeding Guidelines.

Results: A total of 600 websites and 2884 apps were screened, and 44 websites and 46 apps met the selection criteria and were analyzed. Most of the websites (26/44) and apps (43/46) were noncommercial, some websites (10/44) and 1 app were commercial and there were 8 government websites; 2 apps had university endorsement. The majority of the websites and apps were rated poor quality. There were two websites that had 100% coverage of information compared to those rated as fair or poor that had low coverage. Two-thirds of the websites (65%) and almost half of the apps (47%) had a readability level above the 8th grade level.

Conclusions: The findings of this unique analysis highlight the potential for website and app developers to merge user requirements with evidence-based content to ensure that information on infant feeding is of high quality. There are currently no apps available to consumers that address a variety of infant feeding topics. To keep up with the rapid turnover of the evolving technology, health professionals need to consider developing an app that will provide consumers with a credible and reliable source of information about infant feeding, using quality assessment tools and evidence-based content.

Knowledge of glaucoma, and its relationship to self-care practices, in a population sample

OBJECTIVE: To determine the level of knowledge of glaucoma in a population-based sample, and its relationship to self-care practices.

DESIGN AND SUBJECTS: A cluster random sample of the Melbourne population 40 years of age and older was interviewed. One thousand seven hundred and eleven residents living in five randomly selected Melbourne metropolitan suburbs, each consisting of two adjacent census collector districts.

MEASURES: Questions were asked concerning respondents' awareness, knowledge and description of the disease. Respondents were also asked the year of their last visit to their eye health care provider.

RESULTS: Seventy per cent of the sample had heard of glaucoma. However, only 22% provided a description that demonstrated a reasonable understanding of the disease. A lack of awareness and knowledge of glaucoma appeared to be negatively related to self-care practices.

CONCLUSION: Serious deficiencies in the basic knowledge of glaucoma in the community was demonstrated. This has significant public health implications as only a small percentage of the at-risk population may present themselves for assessment and treatment. Informing the community about glaucoma is an important step in promoting preventative ophthalmic care and reducing visual impairment and blindness.

Three strategic dimensions of information security in ecommerce : a literature review based conceptual model

Important eCommerce requirements are a robust and secure technical infrastructure, and the ability to ensuring the security of information, and to satisfying certain related legal requirements. In this paper, based on a literature review, we present a high-level conceptual model of information security in eCommerce, consisting of three strategic dimensions: protecting organizations' information, satisfying certain legal requirements, and enabling trusted and secure electronic transactions. Our conceptual model can be used by eCommerce managers as a tool in the strategic planning and management process, to better understand and communicate the inter-dependencies between business and legal requirements. The model can also be used for devising the goals and objectives relevant to their specific organization, for designing the policies that are needed, and deciding how technology will be managed and what training is required.

The tri-dimensional role of information security in E-business : a managerial perspective

The effective management of information and its associated infrastructure is critical in electronic business. Failure to exercise due diligence in information assurance and security may lead to lost revenue or business opportunities, brand and reputation erosion, adverse media publicity, scrutiny from consumer advocates and even lawsuits. Traditionally, information security was approached in terms of goals. Yet, the goalsoriented approach may be a flawed one. In this paper, we adopt a conceptual analytical approach and propose a tri-dimensional understanding of information security in electronic business. Our approach can help managers better understand and communicate the information security’s role in e-business and the inter-dependencies between business and legal requirements, for devising the goals, objectives and policies relevant to their organization.

Change happens: acceptance of 'impermanence' and 'flow' in teachers' professional reflections on technology and change

For several years the authors of this paper have monitored the use of information and communication technologies (ICT) in primary and secondary schools. In this paper they report on their work in progress, focusing particularly on data collected via teacher interviews in 2003. It is a 'good news' story that celebrates a shift in the way school teachers approach ICT, and that shows that teachers are a lot more comfortable with ICT than the authors have previously observed. The authors argue that a significant transition has occurred in the hardware, software and 'warmware', the people and how they can work with the hardware and software as part of their pedagogy. Existing research tends to construct change as something that has to be planned, prepared for and managed (eg. Fullan, 1997), and as something that teachers often resist (eg. Cuban, 1993; Grunberg & Summers, 1992; Hodas, 1998). This paper is distinctive in drawing on Eastern approaches to understanding change. Through an examination of the concepts of "impermanence" and "flow," and how they apply to ICT, schools and teachers' work, we seek to demystify change: Change happens, has happened and will continue to happen. We conclude that teachers' increased familiarity with, and increasingly relaxed approach to, ICT has led to a shift in their attentions, such that they are less concerned with obtaining and mastering particular software and hardware, and more concerned with pedagogy and student learning.

The repatriation experience of the Chinese spouse in New Zealand

This study examines the adjustment process and the adaptability of the Chinese migrant spouses’ in Auckland, New Zealand. A total of 97 spouses participated in a survey from a random sample of 200. The results suggest that both anticipatory and in-country experiences are relevant to adjustment. The results of the study, specifically suggest that the adjustment process experienced by the Chinese spouses in the New Zealand environment is based on a number of factors such as (1) the amount of information and knowledge of New Zealand they have prior to arrival in New Zealand, (2) the backgrounds of the spouses, (3) their experiences prior to and on arrival in New Zealand, and (4) their ability to cope in the new environment.

Pedagogy of oppressed community engagement : socially inclusive visioning of urban change

It is generally accepted that good practice in policy making and urban change initiatives requires community engagement, where community-based approaches are emphasised as a means of socially inclusive visioning. Communities expect greater transparency, accountability and engagement. This expectation is not always met, with many studies focusing on the perceived tickbox effect - where engagement is a process that has to be undertaken rather than being welcomed and embraced as an integral part of planning for urban change. This paper explores multi-disciplinary concepts and looks at ways these can be linked to community engagement in planning, particularly in larger urban Councils. In this brief glimpse at the wide variety of disciplines that could be drawn on, the paper uses information systems, teaching models, organisational theory and public policy to highlight the potential for altering concepts of community engagement. It concludes that, from these particular examples: the use of double-loop learning could help to empower the community (from organisational theory), collaboration and participation necessitate the co-ordination and exchange of information and knowledge within and between organisations (information systems), the preconception that the authority holds all the knowledge ready to be handed out to the community (teaching models) needs to be challenged, and partnerships are important in empowering people (public policy).

Becoming numerate with information and communications technologies in the twenty-first century

This article draws on data from a three-year Australian Research Council-funded study that examined the ways in which young children become numerate in the twenty-first century. We were interested in the authentic problem-solving contexts that we believe are required to create meaningful learning. This being so, our basic tenet was that such experiences should involve the use of information and communications technologies (ICT) where relevant, but not in tokenistic ways. This article highlights learning conditions in which young children can become numerate in contemporary times. We consider ‘academic’ or ‘school-based’ mathematical tasks in the context of a Mathematical Tasks Continuum. This continuum was conceptualised to enable focused and detailed thinking about the scope and range of mathematical tasks that young children are able to engage within contemporary school contexts. The data from this study show that most of the tasks the children experienced in early years mathematics classes were unidimensional in their make up. That is, they focus on the acquisition of specific skills and then they are practiced in disembedded contexts. We suggest that the framework created in the form of the Mathematical Tasks Continuum can facilitate teachers thinking about the possible ways in which they could extend children’s academic work in primary school mathematics, so that the process of becoming numerate becomes more easily related to authentic activities that they are likely to experience in everyday life.

Responses and relationship dynamics of men and their spouses during active surveillance for prostate cancer: health literacy as an inquiry framework

BACKGROUND: Early stage prostate cancer patients may be allocated to active surveillance, where the condition is observed over time with no intervention. Living with a cancer diagnosis may impose stress on both the men and their spouses. In this study we explore whether the scores of and verbal responses to a Health Literacy Questionnaire can be used to identify individuals in need of information and support and to reveal differences in perception and understanding in health related situations within couples. METHODS: We used the nine-domain Health Literacy Questionnaire (HLQ) as a framework to explore health literacy in eight couples where the men were on active surveillance for prostate cancer progression. Scores were calculated for each domain for both individuals. For each couple differences in scores were also calculated and related to the informants' self-reported experiences and reflections in relation to participating in an active surveillance program. Also an inductive analysis was performed to identify themes in the responses and these themes were compared to those of HLQ. RESULTS: The men tended to score higher than their spouses. There was no consistent relation between scores and the reported experiences and reflections. However, some interesting patterns emerged, e.g. in two of the three couples with the largest within couple differences in HLQ scores, responses revealed discrepancies in how the men and their spouses perceived their situation. Also, three themes emerged which related to six of the HLQ domains, i.e. involvement of spouses and other people around the men; support from and interaction with healthcare professionals; and use of the Internet for information retrieval. CONCLUSIONS: Using the HLQ as an interview framework provided insight into the differences within couples and provided new perspectives on their experiences, including their contact with health professionals and the patient-spouse interaction when dealing with prostate cancer. The HLQ used as a dialogue tool may be an adjunct to assist healthcare providers to understand the need for support and information of men with prostate cancer on active surveillance and the dynamics within couples.

Southern anthropology - a history of Fison and Howitt's Kamilaroi and Kurnai

From far-flung sites in Australia and the Pacific Islands, Lorimer Fison and A. W. Howitt produced the landmark study Kamilaroi and Kurnai (1880). Their book revealed the complexity of Aboriginal and Pacific Island societies and changed the course of anthropology in the early years of the discipline. Using archival sources and an innovative approach, Southern Anthropology explores the research, writing and reception of Kamilaroi and Kurnai. Historical chapters track Fison and Howitt's collection and analysis of anthropological material in the context of raging debates about the evolution of humans. This narrative is interspersed with an introduction to the kinship and social organisation of Aboriginal and Pacific Island people that highlight the enduring value of Fison and Howitt's methods and the resurgence of their questions in contemporary anthropology. Southern Anthropology is designed to be read across disciplinary boundaries.

Asset identification in information security risk assessment: A business practice approach

Organizations apply information security risk assessment (ISRA) methodologies to systematically and comprehensively identify information assets and related security risks. We review the ISRA literature and identify three key deficiencies in current methodologies that stem from their traditional accountancy-based perspective and a limited view of organizational "assets". In response, we propose a novel rich description method (RDM) that adopts a less formal and more holistic view of information and knowledge assets that exist in modern work environments. We report on an in-depth case study to explore the potential for improved asset identification enabled by the RDM compared to traditional ISRAs. The comparison shows how the RDM addresses the three key deficiencies of current ISRAs by providing: 1) a finer level of granularity for identifying assets, 2) a broader coverage of assets that reflects the informal aspects of business practices, and 3) the identification of critical knowledge assets.

Working and learning in vocational education and training in the knowledge era : final report of the professional development for the future project

This Report summarises the outcomes of the phases of the Professional
Development for the Future Project and presents the implications of this research for professional development of staff in Vocational Education and Training (VET), as they become knowledge workers.

These shifts are occurring within the knowledge era. Distinguishing features of this era are summarised into four broad areas:
- the importance and value placed on knowledge in organisations
- the time span of discretion
- the complexity of relationships, and
- the ubiquitous nature of information and communication technology.

It is within this context that work is currently performed, and understanding this context provides the foundation for considering new capabilities required in the knowledge era.
Key capabilities required of knowledge workers to work effectively in the
knowledge era were drawn together from an analysis of the theoretical literature and the results of interviews with knowledge workers. The core capabilities identified include:
- adaptive problem solving – becoming designers as well as problem -
solvers
- rapid knowledge gathering and sharing with others
- discriminating between relevant and irrelevant information, and
- understanding and working effectively with the organisation’s culture.

Knowledge era characteristics and knowledge worker capabilities have been mapped to each other illustrating conceptual linkages between these two areas.

Professional development themes drawn from interviews with knowledge
workers are presented. While global trends in knowledge work have been well documented, the impact of these trends on the capabilities of workers, and the ways in which knowledge workers develop these capabilities is less well understood. Their learning methods challenge our current thinking in relation to the ways in which workers acquire skills and knowledge. Some of the professional development methods include seeking exposure to new ideas from a wide variety of sources, embracing intense learning opportunities, and using relationships to increase knowledge.

‘Thought pieces’ (see p17 ff) commissioned for this Project, as well as
subsequent interviews with the authors, provided further insights into the
professional development of knowledge workers. The implications of these insights are an extension of earlier themes and emphasise:
- the emergent nature of knowledge work
- the importance of relationships that facilitate knowledge sharing
- coherent conversations and dialogue
- collaborative work and generosity.

A key insight is the shift from thinking about knowledge work in terms of
borrowed knowledge to an emphasis on generated knowledge within a context.

Data from focus groups of the Project provide further insights for knowledge worker professional development. These augment the perspectives of the earlier data analysis but also add greater emphasis to:
- the clear and direct relationship between professional development and
work and career aspirations of knowledge workers,
- the relationship of professional development to the organisational
mission, and
- the issues of managing and leading knowledge workers and their
development.

As part of this analysis the defining features of organisational life in VET were reviewed in relation to effective professional development of knowledge workers.

The final section of the Report revisits the core dimensions of the Project.
Concise commentaries on working and learning in the knowledge era,
professional development in the knowledge era, and leadership and
management in the knowledge era are presented.

The Report concludes with a discussion of the enablers of professional
development for knowledge workers in VET. This discussion is introduced by a re-statement of the VET sector’s positioning in the knowledge era and the consequences of this for VET managers an d staff in terms of complexity, uncertainty and diminished prospects for accurate predictiveness. The enablers comprised:
- integration of information technology into socio -technical systems
- greater understanding of the organisation from within
- connecting staff to the organisation’s fundamental identity
- connecting to the work and career trajectories of workers
- establishing work structures which integrate the use of professional
development resources with knowledge work
- providing workers with the autonomy to design their own professional
development activities
- building professional development into the iterative nature of knowledge
work, and
- creating organisational contexts that value intuitive thinking and working.

Professional development needs to be thou ght of in a much broader context in the knowledge era. What each VET staff member knows and shares will become increasingly central to their work, and in that sense all VET workers require capabilities for knowledge work. This report accurately describes t he VET context, the capabilities required, and the organisational enablers that will promote ‘knowing’ and thus embed a new style of professional development within VET.