Scope of practice of occupational therapists working in Victorian community health settings

Background/aim: Current health policy places emphasis on community-based health care and it is expected that there will be an increase in the number of people receiving care in community settings. This study aimed to examine the profile and scope of practice of occupational therapists working in Victorian community health settings and the amount and type of health promotion activity incorporated into their role.
Method:  An anonymous postal questionnaire was sent to 205 community-based Victorian occupational therapists. One hundred and one (49.3% response rate) questionnaires were returned, with 72 respondents (35.1%) meeting study inclusion criteria. A descriptive research design was used to address study aims.
Results:  Results indicate that the majority of community health occupational therapists are experienced practitioners, have a varied scope of practice and report a high level of job satisfaction. Compared with previous studies, there is an increase in new graduate occupational therapists starting their career in community health settings, a greater number of part-time workers and a diversification of clinical and non-clinical roles. Barriers to practice that exist include high demand for service, limited funding and time spent on administrative tasks. Although health promotion was regarded as an important role of community health workers, a large number of therapists were not involved in this activity because of limited knowledge and clinical work taking priority.
Conclusion: Study findings have implications for occupational therapy training, and there is a clear need for input at policy level to address the significant resource allocation issues raised.

The Australian and New Zealand dialysis workforce

Aim: To capture a "snapshot" of the current Australian and New Zealand dialysis workforce in order to contribute to the future renal workforce challenges.

Methods: A web-based survey of dialysis managers (n=221) were asked fifteen questions relating to demographics, age, full-time equivalent information, workforce designation, post-registration qualifications, subjective perceptions of staffing levels, staffing strategies and future dialysis research recommendations

Results: In Australia in 2008 there were 2433 registered nurses, 188 enrolled nurses and 295 dialysis professionals (technicians) and 327 registered nurses (RNs), 8 enrolled nurses (ENs) and 64 dialysis professionals in New Zealand. There were significant variations in staff/patient ratios, workforce profiles and post-registration qualifications. There is a significant association between staff/ patient and home dialysis ratios. A high proportion of renal staff worked part-time, particularly in Australia. The dialysis workforce reflects the aging nature of the general nursing population in Australia and New Zealand. The majority of dialysis nurse managers perceived they had sufficient staff.

Conclusion: Workforce variations found in this study may be useful to identify future workforce challenges and strategies.

The Australian and New Zealand dialysis workforce study in the international context

Background: Given increasing demand for renal replacement therapy, this study sought to identify of key workforce issues facing dialysis units, based on a “snapshot” of the current workforce.

Methods: A web-based survey of all dialysis unit managers in Australia and New Zealand, in October 2008, about their workforce.

Results: A significant minority of dialysis staff in most regions were not registered nurses. Many renal registered nurses worked part time. Staff/patient ratios in dialysis units varied significantly by region, reflecting the relative prevalence of home therapies. Most dialysis units were generally adequately staffed. The proportion of registered nurses with specific renal qualifications varied significantly by region.

Conclusion: The changing character of the workforce in the dialysis unit in the future will require clarification of the relationships between different categories of dialysis staff. Specialty education for nurses needs to be oriented to equipping staff to be effective in their changing work environment.

Communication at the bedside to enhance patient care : a survey of nurses’ experience and perspective of handover

Strategies to support continuity of care and improve patient safety during clinical handover have been developed. The aims of this study were to identify the strengths and limitations in current practice of nursing clinical handover and implement a new bedside handover process. A total of 259 nurses completed a cross-sectional survey at change of shift on 1 day, which was followed by an audit of the pilot implementation of bedside handover. The survey results showed great variation in the duration, location and method of handover with significant differences in the experience of nurses employed part-time compared with full-time. Following implementation of standardized bedside handover on two wards, the audit revealed significant improvement in the involvement of patients, use of Situation-Background-Assessment-Recommendation, active patient checks and checking of documentation. These findings suggest the use of standardized protocols and communication tools for bedside handover improve continuity of patient care

Financial structure and policy of Australia's retirement system

Inoreasing life expectancies for both males and females in the Asia-Pacific region have resulted in an ageing population. Given an ageing p'opulation, adequate income is of increasing importance to people who will experience longer periods in retirement. This paper provides an overview of the structure of the Australian retirement system which includes a means-tested government provided age pension, retirement savings and voluntary savings. Despite policy Initiatives to boost retirement savings and income, it is concluded that due to the relative immaturity of this system it will fail to provide many community groups (baby-boomers, females, low income earners, long-term unemployed, part-time workers) with an adequate retirement income.

Trends in Australian contact lens prescribing during the first decade of the 21st century (2000–2009)

Purpose:  The aim was to document contact lens prescribing trends in Australia between 2000 and 2009.

Methods:  A survey of contact lens prescribing trends was conducted each year between 2000 and 2009. Australian optometrists were asked to provide information relating to 10 consecutive contact lens fittings between January and March each year.

Results:  Over the 10-year survey period, 1,462 practitioners returned survey forms representing a total of 13,721 contact lens fittings. The mean age (± SD) of lens wearers was 33.2 ± 13.6 years and 65 per cent were female. Between 2006 and 2009, rigid lens new fittings decreased from 18 to one per cent. Low water content lenses reduced from 11.5 to 3.2 per cent of soft lens fittings between 2000 and 2008. Between 2005 and 2009, toric lenses and multifocal lenses represented 26 and eight per cent, respectively, of all soft lenses fitted. Daily disposable, one- to two-week replacement and monthly replacement lenses accounted for 11.6, 30.0 and 46.5 per cent of all soft lens fittings over the survey period, respectively. The proportion of new soft fittings and refittings prescribed as extended wear has generally declined throughout the past decade. Multi-purpose lens care solutions dominate the market. Rigid lenses and monthly replacement soft lenses are predominantly worn on a full-time basis, whereas daily disposable soft lenses are mainly worn part-time.

Conclusions:  This survey indicates that technological advances, such as the development of new lens materials, manufacturing methods and lens designs, and the availability of various lens replacement options, have had a significant impact on the contact lens market during the first decade of the 21st Century.

Survey of contact lens prescribing to infants, children, and teenagers

Purpose. To determine the types of contact lenses prescribed for infants (aged 0 to 5 years), children (6 to 12 years), and teenagers (13 to 17 years) around the world.

Methods. Up to 1000 survey forms were sent to contact lens fitters in each of 38 countries between January and March every year for 5 consecutive years (2005 to 2009). Practitioners were asked to record data relating to the first 10 contact lens fits or refits performed after receiving the survey form.

Results. Data were received relating to 105,734 fits [137 infants, 1,672 children, 12,117 teenagers, and 91,808 adults (age ≥18 years)]. The proportion of minors (<18 year old) fitted varied considerably between nations, ranging from 25% in Iceland to 1% in China. Compared with other age groups, infants tend to be prescribed a higher proportion of rigid, soft toric, and extended wear lenses, predominantly as refits for full-time wear, and fewer daily disposable lenses. Children are fitted with the highest proportion of daily disposable lenses and have the highest rate of fits for part-time wear. Teenagers have a similar lens fitting profile to adults, with the main distinguishing characteristic being a higher proportion of new fits. Orthokeratology fits represented 28% of all contact lenses prescribed to minors.

Conclusions. Patterns of contact lens prescribing to infants and children are distinctly different to those of teenagers and adults in a number of respects. Clinicians can use the data presented here to compare their own patterns of contact lens prescribing to minors.

Global forms and local forces : PhD enrollments and graduations in Australia, Canada, the Czech Republic, the United Kingdom, and the United States

 This chapter presents and discusses data from five different nations—Australia, Canada, the Czech Republic, the United Kingdom, and the United States—on doctoral candidates and graduates. These data are from governmental and institutional sources for the years 1998–2004, a sample that enables changes across a five-year span to be identified. They span important basic characteristics, such as gender, age, discipline, and study load (that is, full-time or part-time study). Therefore, readers can see national as well as international trends and differences in such characteristics and can match these to equivalent and/or contemporary data in their own nations. The five countries considered here are among those whose data were discussed at the 2007 CIRGE research synthesis meeting in Australia. Although these countries are not universally representative of doctoral education, their practices do offer a vivid sense of how vastly the enterprise of doctoral education differs in its scope and dimensions around the world

Negotiating discursive positions within a police culture: critical reflections of a student researcher

I traverse a number of identity boundaries every day within a work context. This paper discusses the blurred boundary of two identities - (1) a part-time PhD student undertaking a cross-jurisdictional study of police training and education and (2) a full-time, ‘unsworn’ employee advising on education and training at a police academy. Study and work are concurrent. I describe myself as a token insider – different, partly accepted, yet tolerated, or alternatively as an outsider-insider. It is taxing to maintain an outsider’s standpoint in a police organisation. My role regularly places me in a position of challenging the dominant ideology, D/discourse (words, beliefs, thinking styles) and subcultures whilst experiencing the imposition of power by the dominant to accept the status quo. Frustration combined with a desire to name and reframe everyday experiences has led me to engage in critical reflection, enlist a critical friend, and undertake doctoral research. As an outsider- nsider, critical reflection is a tool that enables me to negotiate discursive positions by questioning my engagement and subject position within and against the taken-for-granted and unquestioned dominant D/discourses.

International survey of rigid contact lens fitting

To determine the extent of rigid contact lens fitting worldwide and to characterize the associated demographics and fitting patterns. Survey forms were sent to contact lens fitters in up to 40 countries between January and March every year for five consecutive years (2007 to 2011). Practitioners were asked to record data relating to the first 10 contact lens fits or refits performed after receiving the survey form. Survey data collected between 1996 and 2011 were also analyzed to assess rigid lens fitting trends in seven nations during this period. Data were obtained for 12,230 rigid and 100,670 soft lens fits between 2007 and 2011. Overall, rigid lenses represented 10.8% of all contact lens fits, ranging from 0.2% in Lithuania to 37% in Malaysia. Compared with soft lens fits, rigid lens fits can be characterized as follows: older age (rigid, 37.3 ± 15.0 years; soft, 29.8 ± 12.4 years); fewer spherical and toric fits; more bifocal/multifocal fits; less frequent replacement (rigid, 7%; soft, 85%); and less part-time wear (rigid, 4%; soft, 10%). High-Dk (contact lens oxygen permeability) (36%) and mid-Dk (42%) materials are predominantly used for rigid lens fitting. Orthokeratology represents 11.5% of rigid contact lens fits. There has been a steady decline in rigid lens fitting between 1996 and 2011. Rigid contact lens prescribing is in decline but still represents approximately 10% of all contact lenses fitted worldwide. It is likely that rigid lenses will remain as a viable, albeit increasingly specialized, form of vision correction.

An international survey of daily disposable contact lens prescribing

The aim was to determine the extent of daily disposable contact lens prescribing worldwide and to characterise the associated demographics and fitting patterns. Up to 1,000 survey forms were sent to contact lens fitters in up to 40 countries between January and March every year for five consecutive years (2007 to 2011). Practitioners were asked to record data relating to the first 10 contact lens fits or refits performed after receiving the survey form. Survey data collected since 1996 were also analysed for seven nations to assess daily disposable lens fitting trends since that time. Data were collected in relation to 97,289 soft lens fits, of which 23,445 (24.1 per cent) were with daily disposable lenses and 73,170 (75.9 per cent) were with reusable lenses. Daily disposable lens prescribing ranged from 0.6 per cent of all soft lenses in Nepal to 66.2 per cent in Qatar. Compared with reusable lens fittings, daily disposable lens fittings can be characterised as follows: older age (30.0 ± 12.5 versus 29.3 ± 12.3 years for reusable lenses); males are over-represented; a greater proportion of new fits versus refits; 85.9 per cent hydrogel; lower proportion of toric and presbyopia designs and a higher proportion of part-time wear. There has been a continuous increase in daily disposable lens prescribing between 1996 and 2011. The proportion of daily disposable lens fits (as a function of all soft lens fits) is positively related to the gross domestic product at purchasing power parity per capita (r(2) = 0.55, F = 46.8, p < 0.0001). The greater convenience and other benefits of daily disposable lenses have resulted in this modality capturing significant market share. The contact lens field appears to be heading toward a true single-use-only, disposable lens market.

Gestational weight gain information: seeking and sources among pregnant women

BACKGROUND: Promoting healthy gestational weight gain (GWG) is important for preventing obstetric and perinatal morbidity, along with obesity in both mother and child. Provision of GWG guidelines by health professionals predicts women meeting GWG guidelines. Research concerning women's GWG information sources is limited. This study assessed pregnant women's sources of GWG information and how, where and which women seek GWG information. METHODS: Consecutive women (n = 1032) received a mailed questionnaire after their first antenatal visit to a public maternity hospital in Melbourne, Australia. Recalled provision of GWG guidelines by doctors and midwives, recalled provided GWG goals, and the obtaining of GWG information and information sources were assessed. RESULTS: Participants (n = 368; 35.7 % response) averaged 32.5 years of age and 20.8 weeks gestation, with 33.7 % speaking a language other than English. One in ten women recalled receiving GWG guidelines from doctors or midwives, of which half were consistent with Institute of Medicine guidelines. More than half the women (55.4 %) had actively sought GWG information. Nulliparous (OR 7.07, 95 % CI = 3.91-12.81) and obese (OR 1.96, 95 % CI = 1.05-3.65) women were more likely to seek information. Underweight (OR 0.29, 95 % CI = 0.09-0.97) women and those working part time (OR 0.52, 95 % CI = 0.28-0.97) were less likely to seek information. Most frequently reported GWG sources included the internet (82.7 %), books (55.4 %) and friends (51.5 %). The single most important sources were identified as the internet (32.8 %), general practitioners (16.9 %) and books (14.9 %). CONCLUSION: More than half of women were seeking GWG guidance and were more likely to consult non-clinician sources. The small numbers given GWG targets, and the dominance of non-clinical information sources, reinforces that an important opportunity to provide evidence based advice and guidance in the antenatal care setting is currently being missed.

Cultural influence on global assessment of higher education service quality: The case of Central Queensland University, Australia

© 2014 by IGI Global. All rights reserved. This study compares students' cultural influence on global assessment of higher education service quality. In particular, this study surveyed the full-time students (that is at least 24 credit points of study in a semester) studying at the Central Queensland University (CQU), Australia. CQU has ten campuses and is one of the largest universities in Australia, with more than 14,000 students, in which 3,000 students are enrolled as full-time students and 11,000 as part-time students. An online survey was undertaken, and 227 responses from full-time students were returned for data analysis. Exploratory factor analysis and confirmatory factor analysis were performed to determine valid and reliable dimensions of perceived service quality. Tests of differences such as ANOVA and t-test were conducted to examine the differences of perceived service quality in terms of four cultural dimensions; namely, power distance, individualism, uncertainty avoidance, and masculinity. Findings show that different cultures perceive service quality differently; especially administrative service quality and physical facilities service quality.

A comparison of different study load classifications and their association to student performance: an exploratory study

Purpose – The purpose of this paper is to investigate the alternative study load measures (dichotomous full-time/part-time classification and the number of units enrolled) and their association to student performance by using student data from a final year accounting unit in a large Australian university.

Design/methodology/approach – Using regression analysis, the authors compare the two measures to ascertain the explanatory power of the two approaches in explaining student performance.

Findings – A positive association is found between study loads and student performance when using the “number of units enrolled” measure. This relationship was not found when the dichotomous measure (full-time vs part-time) was used. The results suggest that a scaled measure of study loads is a better measure compared to a binary (dichotomous) measure.

Research limitations/implications – The study will assist future researchers to better control for study loads, and also to gain a better understanding of the association between study loads and student performance. This may possibly assist educational institutions and academics to use a more appropriate pedagogical design in the structure of courses when determining study load allocations across the different cohorts.

Practical implications – This study will help in methodology of future researchers controlling for study loads and student performance.
Originality/value – The study adds to existing literature by providing an alternate study load measure in methodology for controlling for student performance.

Career facilitators and obstacles of Australian football development coaches

Career development is considered integral to the success of individuals, organisations and professions. Coaches play a vital role in the success of sport, yet little is known about their career development. Despite the advances in career development for athletes, there has been very little scholarly attention, nor resources provided for coach career development, especially for coaches working outside elite and professional sport. This pilot study explored the career development facilitators and obstacles of junior development Australian football coaches. Semi-structured interviews were used to collect data on the career development of six practicing junior development Australian football coaches. These six (of only 12 employed) coaches worked in the main elite junior development league for Australian football, the Transport Accident Commission Cup. The themes that emerged from the data revealed that the career development of junior development Australian football coaches was facilitated first by their high motivation to coach because of their enjoyment of seeing young players develop and transition into the elite competition. The second facilitator was the coach’s awareness of their career development needs and their willingness to do their own career development despite limited opportunity, guidance or support. The key obstacles to Transport Accident Commission Cup coach career development included a lack of opportunity to spend time at elite clubs to observe and interact with elite coaches; a lack of time due to having a non-coaching job to financially support their coaching work and their family as well; the high demands of the coaching role had a negative impact on their work–life balance and often conflicted with time they would rather spend with their families; and finally, the lack of institutional support for coaches who were asked to work long hours for low wages and little reward despite their vital role in the elite player development pathway for the Australian Football League. This research suggests that junior development Australian football coaches have a clear understanding of their role and how it changes as their career develops; however, the coaches are limited by external forces in their career development. Junior development Australian football coaches are vital for Australian Football League development; however, there is disconnection between Australian Football League goals and their capacity to nurture elite athletes into the sport’s system due to part-time coaching roles, limited resources and few opportunities for coaches to develop their careers.