Patient safety ethics and human error management in ED contexts part I : development of the global patient safety movement

In recent years there has been increasing recognition internationally that health care is not as safe as it ought to be and that patient safety outcomes need to be improved. To this end patient safety has become the focus of a world-wide endeavour aimed at reducing the incidence and impact of preventable human errors and related adverse events in health care domains. The emergency department has been identified as a significant site of preventable human errors and adverse events in the health care system, raising important questions about the nature of human error management and patient safety ethics in rapidly changing environments. In this article (the first of a two-part discussion on the subject) an overview of the incidence and impact of preventable adverse events in ED contexts is explored. The development of a ‘culture of safety’ in other hazardous industries and the ‘lessons learned’ and applied to the health care industry are also briefly examined. In a second article (to be presented as Part II), some of the ethical tensions that have arisen in the context of implementing patient safety processes and their possible implications for ED contexts are explored.

Fundamental movement skills - How do primary school children perform? The 'Move it Groove it' program in rural Australia

Child Fundamental Movement Skills (FMS) underpin active lifestyles yet little is known of their distribution and mastery.

‘Move it Groove it’ project rated proficiency of primary school children (n=1045, 18 schools) in skills of balance, throw, catch, sprint, hop, kick, side gallop and jump. Rating categories were ‘mastery’, ‘near mastery’ or ‘poor’ (ie mastered all, all but one, or less of the five to six components of an FMS).

Less than half of all child tests were rated at mastery (21.3%) or near mastery (25.7%) level. In grade three, 75.4% of children achieved mastery or near mastery (MNM) in static balance but less than half did so for any other FMS. In grade four, 59.0% achieved MNM in the side gallop and 56.0% in the catch but less than half did so for any other FMS.

Although the highest percent mastery for both genders was for the balance, the skills best performed thereafter by boys (throw and kick) rated poorest for girls. Conversely the hop and side gallop which rated, after balance, as the skills best mastered by girls, were among the more poorly performed skills for boys.

The low prevalence of FMS mastery found in this survey suggests that there may be great potential to improve fundamental movement skills of primary aged children in many parts of rural Australia. Even if the aim were for children to achieve near mastery levels, the improvement could be substantial in every skill category. Where appropriate, gender differences in mastery might easily be addressed by tailored physical education programs and modification of social and physical environments.

Melbourne's indigenous plants movement : the return of the natives

This thesis examines Greater Melbourne’s indigenous plants movement from the 1930s to the early twenty first century. It demonstrates the important scientific and educational role of the public intellectual, Professor John Turner, and of the Melbourne University Botany School which he led for thirty five years. The case study of the movement within the City of Sandringham and its successor the City of Bayside reveals how the inhabitants of an urbanised are responded to threats to the indigenous trees and wildflowers of their neighbourhood, stimulating botanists to assist them and using political means in order to achieve their conservation objectives. The thesis draws upon a range of local archives, conservation literature and private papers.

Occupational therapists and the use of constraint-induced movement therapy in neurological practice

There is adaquate evidence for supporting the use of constraint-induced movement therapy (CIMT) in post-stroke rehabilitation. However, the actual usage of CIMT in routine occupational therapy practice appears limited. Further research is required to study why this might be so.

Structural change in the Australian trade union movement

This thesis used a 'structural events' approach to examine changes in Australian trade union structure between 1969 and 1996. Broad labour market trends and legal and industrial factors resulted in a high level of union formations and dissolutions between 1969 and 1984. Post-1985, agency factors produced a merger wave.

Assessment of movement participation for children with developmental coordination disorders

The Caregiver Assessment of Movement Participation was developed to identify children of 5-10 years old for movement participation difficulties in home contexts. Its psychometric properties were investigated including its usefulness as a screening instrument using both classical test theory methods and Rasch analysis. Results confirmed its validity and reliability.

Visual discrimination and reproduction of movement by individuals with an intellectual disability

This study investigates the capacity of individuals with an intellectual disability to make accurate discriminations of computer-generated displays and also to reproduce the characteristics of those displays. The findings suggest that the learning of everyday motor skills in this population may be hampered by difficulties in visually perceiving important characteristics of the demonstration. Procedures, employed for teaching these skills to intellectually disabled, are being reassessed in the light of these findings.

The idiosyncratic movement potential of the dancer's subject body in the work "Deep map"

An investigation into choreographic processes employed within contemporary modern dance. This involved the exploration of working methods used in the making of "Deep map" nos.1, 2 & 3, presented in Melbourne from 1997-2000. The focus of that method was the placement of the dancer as 'subject' whilst maintaining the role of the choreographer as 'auteur'.

Dance movement therapy in Australia : a survey of practitioners and practice

This article reports the results of a survey of 41 dance-movement therapy practitioners in Australia. Issues for dance-movement therapy practice in Australia were investigated within the themes of practitioners; programs and clients, and philosophical and industrial concerns. Overall, it was apparent that the dance-movement therapy profession in Australia is both diverse and homogenous: therapists’ professional orientations and backgrounds, and the types of settings in which they work, are very diverse, but therapists are much more similar in their ages, gender, cultural backgrounds and geographic location. The issues raised by the variation and lack of diversity are discussed, along with possible strategies to address them.

The contribution of upper limb and total body movement to adolescents’ energy expenditure whilst playing Nintendo Wii

Little research documents the contribution of upper limb and total body movement to energy expenditure (EE) during active video gaming. To address this, EE, heart rate (HR), and, upper limb and total body movement were assessed in 11- to 17-year-old adolescents whilst playing three active (Nintendo Wii) and one sedentary (XBOX 360) video games. Non-dominant upper limb activity, EE and HR were significantly greater during Wii Sports boxing [mean 267.2 (SD 115.8) J kg−1 min−1; 136.7 (24.5) beats min−1] than tennis or bowling (P ≤ 0.044). For all active games hip activity best predicted EE (R 2 ≥ 0.53), with two-measure models of HR and single-site activity data, and multi-site activity data, similarly explaining the variance in EE (R 2 ≥ 0.64). The physiological cost of upper-body orientated active video games increased when movement of both upper limbs was encouraged. Improvements in EE explanatory power provide support for multi-site activity monitoring during unique, non-ambulatory activities.

Fundamental movement skills in children and adolescents : review of associated health benefits

The mastery of fundamental movement skills (FMS) has been purported as contributing to children's physical, cognitive and social development and is thought to provide the foundation for an active lifestyle. Commonly developed in childhood and subsequently refined into context- and sport-specific skills, they include locomotor (e.g. running and hopping), manipulative or object control (e.g. catching and throwing) and stability (e.g. balancing and twisting) skills. The rationale for promoting the development of FMS in childhood relies on the existence of evidence on the current or future benefits associated with the acquisition of FMS proficiency. The objective of this systematic review was to examine the relationship between FMS competency and potential health benefits in children and adolescents. Benefits were defined in terms of psychological, physiological and behavioural outcomes that can impact public health. A systematic search of six electronic databases (EMBASE, OVID MEDLINE, PsycINFO, PubMed, Scopus and SportDiscus) was conducted on 22 June 2009. Included studies were cross-sectional, longitudinal or experimental studies involving healthy children or adolescents (aged 3–18 years) that quantitatively analysed the relationship between FMS competency and potential benefits. The search identified 21 articles examining the relationship between FMS competency and eight potential benefits (i.e. global self-concept, perceived physical competence, cardio-respiratory fitness [CRF], muscular fitness, weight status, flexibility, physical activity and reduced sedentary behaviour). We found strong evidence for a positive association between FMS competency and physical activity in children and adolescents. There was also a positive relationship between FMS competency and CRF and an inverse association between FMS competency and weight status. Due to an inadequate number of studies, the relationship between FMS competency and the remaining benefits was classified as uncertain. More longitudinal and intervention research examining the relationship between FMS competency and potential psychological, physiological and behavioural outcomes in children and adolescents is recommended.