Dispositional and maturational development through a competency based training intervention : getting to the heart of the matter

Presents a formative perspective on vocational learning that proposes that vocational competence is dependent upon dispositional development, which in turn results in moves towards maturation. Further, that dispositional and maturational outcomes occur as a result of a lifetime goal-setting intervention employed prior to training Reports qualitative and quantitative research with unemployed adults engaging in vocational education that resulted in four findings. Firstly, that while Training Packages describe assessable outcomes in competency-referenced terms, trainees describe learning outcomes in non-competency referenced terms. Secondly, that vocational trainees describe their learning in terms of dispositional outcomes, that is, in terms of values, interests and attitudes. Thirdly, that dispositions can be categorised in terms of maturational concepts. Fourthly, in support of incremental theory, that trainees made moves towards maturation as a result of a lifetime goal-setting intervention employed prior to training.

Learning opportunities for Australian prevocational hospital doctors: exposure, perceived quality and desired methods of learning.

Objective:

To survey prevocational doctors working in Australian hospitals on aspects of postgraduate learning.
Participants and setting:

470 prevocational doctors in 36 health services in Australia, August 2003 to October 2004.
Design:

Cross-sectional cohort survey with a mix of ordinal multicategory questions and free text.
Main outcome measures:

Perceived preparedness for aspects of clinical practice; perceptions of the quantity and usefulness of current teaching and learning methods and desired future exposure to learning methods.
Results:

64% (299/467) of responding doctors felt generally prepared for their job, 91% (425/469) felt prepared for dealing with patients, and 70% (325/467) for dealing with relatives. A minority felt prepared for medicolegal problems (23%, 106/468), clinical emergencies (31%, 146/469), choosing a career (40%, 188/468), or performing procedures (45%, 213/469). Adequate contact with registrars was reported by 90% (418/465) and adequate contact with consultants by 56% (257/466); 20% (94/467) reported exposure to clinical skills training and 11% (38/356) to high-fidelity simulation. Informal registrar contact was described as useful or very useful by 94% (433/463), and high-fidelity simulation by 83% (179/216). Most prevocational doctors would prefer more formal instruction from their registrars (84%, 383/456) and consultants (81%, 362/447); 84% (265/316) want increased exposure to high-fidelity simulation and 81% (283/350) to professional college tutorials.
Conclusion:

Our findings should assist planning and development of training programs for prevocational doctors in Australian hospitals.

Peripartum urinary incontinence : a study of midwive's knowledge and practices

Urinary incontinence impacts on women's quality of life and their wellbeing. The objectives of this study were to obtain knowledge and information on midwives’ assessment and management practices of urinary incontinence in childbearing women and to explore midwives’ knowledge of risk factors associated with developing urinary incontinence. A non-experimental descriptive research design was used, and participants were current members of the Victorian branch of the Australian College of Midwives. Data was obtained using a survey tool that contained both qualitative and quantitative questions. Key findings indicated that the majority of midwives do not assess women for urinary incontinence during the peripartum period and guidelines for bladder management in maternity services were lacking.

The DALY, context and the determinants of the severity of disease: an exploratory comparison of paraplegia in Australia and Cameroon

This paper summarises the findings of an empirical investigation of some of the technical and social assumptions on which the disability adjusted life year (DALY) is based. The objectives of the study were to examine the notion that the burden of disease is broadly similar without regard to country, environment, gender or socio-economic status and to develop detailed descriptions of the experiences of the burden of disease as they related to these contextual factors. The study was a multi-factorial exploratory study employing qualitative and quantitative techniques to obtain data on the effects of country (development), environment (urban versus rural), gender and socio-economic status on people with paraplegia. The data provided an extensive and detailed compilation of context rich descriptions of living with paraplegia. Striking features of the data were the differences between countries with respect to the impact of the health conditions on functioning and highlight a context in which paraplegia of like clinical severity can be fatal in one environment and not in another. While there has been some focus on the control of social determinants of disease, there has been little work on the social determinants of the severity of disease. The underlying assumptions of the DALY, which ignore context in the assessment of the burden of disease, risk exacerbating inequalities by undervaluing the burden of disease in less-developed countries. There is a need to continue to subject the development of indicators to rigorous debate to determine a balance between the assumption of a global “average social milieu” and the treatment of each individual as belonging to their own context in the assessment of population health in order for indicators to be meaningful cross-culturally.

Coronary artery stenoses: detection with calcium scoring, CT angiography, and both methods combined

PURPOSE: To investigate prospectively the relative accuracy of computed tomographic (CT) angiography, calcium scoring (CS), and both methods combined in demonstrating coronary artery stenoses by using conventional angiography as the reference standard. MATERIALS AND METHODS: The study was approved by the institutional review board Human Research Ethics Committee, and all patients completed written informed consent. Fifty patients (40 men, 10 women) aged 62 years ± 11 (± standard deviation) who were suspected of having coronary artery disease underwent both conventional coronary angiography and multisection coronary CT angiography with CS. Sensitivity and specificity of CS, CT angiography, and both methods combined in demonstrating luminal stenosis greater than or equal to 50% were determined for each arterial segment, coronary vessel, and patient. Receiver operating characteristic (ROC) curves were generated for CS prediction of significant stenosis, and the Mann-Whitney U test was used for comparison of CS between groups. RESULTS: When used with segment-specific electrocardiographic phase reconstructions, CT angiography demonstrated stenosed segments with 79% sensitivity and 95% specificity. Mean calcium score was greater in segments, vessels, and patients with stenoses than in segments, vessels, and patients without stenoses (P < .001 for all); nine (16%) of 56 stenosed segments, however, had a calcium score of 0. The patient calcium score correlated strongly with the number of stenosed arteries (Spearman {rho} = 0.75, P < .001). CS was more accurate in demonstrating stenosis in patients than in segments (areas under ROC curve were 0.88 and 0.74, respectively). CT angiography, however, was more accurate than CS in demonstrating stenosis in patients, vessels, and segments. The sensitivity and specificity of CS varied according to the threshold used, but when the calcium score cutoff (ie, >150) matched the specificity of CT angiography (95%), the sensitivity of CS in demonstrating stenosed segments was 29% (compared with 79% for CT angiography). Combining CT angiography with CS (at threshold of 400) improved the sensitivity of CT angiography (from 93% to 100%) in demonstrating significant coronary disease in patients, without a loss of specificity (85%); this finding, however, was not statistically significant. CONCLUSION: CT angiography is more accurate than CS in demonstrating coronary stenoses. A patient calcium score of greater than or equal to 400, however, can be used to potentially identify patients with significant coronary stenoses not detected at CT angiography.

The interface of acute and aged care: the role of the nurse in provincial area

Objective: This study was to investigate issues that arose from pre-admission to post-discharge, for people in Toowoomba, Queensland over the age of 65 admitted to an acute facility. This paper concentrates on a significant concern that emerged from the latge amount of data collected during this project, that is, the role of the nurse in the continuum of health care involving elderly people.

Method: The study involved a multi-site, multi-agency and multi-method (qualitative and quantitative) approach. Data was collected from regional service providers, the Department of Health and Aged Care (DHAC), the Australian Bureau of Statistics (ABS), Home and Community Care (HACC), the Aged Care Assessment Team (ACAT), elderly people who had been discharged from regional hospitals and their carers, residents of regional aged care facilities, area health professionals and elderly regional hospital inpatients.

Results: The data indicated that nurses in this provincial area currently play a limited role in preadmission planning, being mostly concerned with elective surgery, especially joint replacements. While nurses deliver the majority of care during hospitalisation, they do not appear to be cognizant of the needs of the elderly regarding post-acute discharge.

Conclusion: The recent introduction of the model of nurse case management in the acute sector appears to be a positive development that will streamline and optimise the health care of the elderly across the continuum in the Toowoomba area. The paper recommends some strategies, such as discharge liaison nurses based in Emergency Departments and the expansion of the nurse case management role, which would optimise care for the elderly person at the interface of care.

Investigating social marketing, benchmarking and public policy development in environmental management

This paper discusses, an application of social marketing relating to pro-environmental awareness and social change. The integration of consumer behaviour theory into social marketing has been highlighted in the literature as requiring greater attention. Social marketing campaigns, like all marketing activities, rely on an understanding of stakeholders' attitudes and motivations in regard to the issue of concern, as well as towards the desired modified behaviour or lack of behaviour. The study highlights the marketing paradigms of benchmarking and social marketing in a not for profit governmental environment. Serrated Tussock has been designated as a weed of national significance and therefore the program has national implications (Thorp 2000). Even though issues associated with introduced species are less publicised than other environmental issues on the world stage, the associated environmental problems are no less severe than those caused by production and consumption activities. Weed control is a widespread problem facing individuals, communities and governments at all levels. A triangulatory approach, involving three distinct phases and incorporating both qualitative and quantitative tools, was used for the research design. The qualitative phase involved focus groups and in depth interviews with landholders, focus groups with professionals in the field and a focus group of key stakeholders. The mail survey resulted in a representative sample of 608 usable responses from the infestation area. The research conducted in this study illustrates how the various stages in the social marketing process were achieved and recommendations consistent with social marketing theory were generated.

Community group volunteer perceptions and awareness of Victorian marine protected areas

In 2004, a Community Based Monitoring (CBM) program for Victoria’s Marine National Parks and Marine Sanctuaries was developed. A key performance area for Victoria’s Marine Protected Area (MPA) Management Strategy is community engagement. This program was developed to incorporate the key performance principles of community education, participation and engagement. CBM involves scientific protocols to monitor different habitat types in a MPA. As part of the CBM project, perceptions and values of MPAs were investigated through a pilot survey of 125 community group volunteers from 4 volunteer groups. Surveys were sent to all community group members which included participants and non-participants in the CBM program. Questions sought qualitative and quantitative information, focusing on personal values of MPAs. The surveys included questions associated with CBM, MPA management and environmental issues affecting the marine environment. Responses from the pilot study indicated that 50% of the volunteers participated in CBM to learn more about scientific research, and 30% wanted to work close to nature. This pilot study will form the basis of a larger-scale study to investigate community group perceptions of MPAs and identifying how to maintain volunteer enthusiasm, interest and motivation in a CBM program.

An integrated student support framework for a Malaysian university

This thesis reports on an investigation at the University Tun Abdul Razak (UNITAR), Malaysia focused on students’ needs for student support services. The research addressed a new problem in distance education concerning institutional practices and strategies for providing student support within blended learning contexts, such as at UNITAR. The thesis addresses important matters related to the use of forms of education to address Malaysia’s social, political and economic development.

The study had two main research purposes. The first purpose was to investigate what barriers UNITAR’s students had to completing their study successfully. The second was to investigate students’ support services needs. The latter was divided into six subsidiary purposes. The first subsidiary purpose was to identify and compare the students’ needs intensity for the four categories of support services: administrative, academic, welfare and post-study services. The second subsidiary purpose was to investigate whether there is any correlation between students’ attributes of age, gender, marital status, number of children, enrollment status, distance from learning centre, academic abilities, course satisfaction and academic achievement, with their support needs. The other subsidiary purposes were to compare needs intensity for the four categories of services between men and women, younger and mature-age students, and lower and higher academic achievers.

The research design employed mixed methods, involving both qualitative and quantitative techniques. A series of interviews was conducted with UNITAR staff members during an inventory study of the University. Then, the students were surveyed through a questionnaire that contained closed-ended and openended questions. After analysing and compiling the results of the survey, another cycle of surveys was conducted with selected staff members through email, to validate the findings and obtain their feedback to the students’ views and their suggestions for future improvement. The quantitative survey data were analysed using SPSS, whereas the qualitative data from interview, survey and email were analysed by using content analysis techniques.

The findings of the study demonstrated that UNITAR’s students have problems in their study, which are related to their demographic and institutional attributes, and these affect their needs for four categories of support services. Generally, students attached the highest priority to academic services, followed by post-study services, administrative services and, lastly, welfare services. Four patterns of associations between students’ attributes and support services needs were identified. In particular, support services needs differences were identified between men and women, younger and mature-age students, and lower achieving and higher achieving students.

Drawing the findings of this study, relevant past studies, contemporary practices and constructive views of scholars from the relevant literature, the thesis concludes by proposing an integrated student support framework for UNITAR and suggest how this may be considered and applied more broadly in similar blended learning contexts in Malaysia and beyond.

Dancing on a moving floor : lay women and the principalship in Catholic education

Female disadvantage has been the explanation given in previous studies to explain the under-representation of laywomen who achieve principalships in Catholic Education. Women, themselves, have overcome many of the barriers that disadvantage them. These include an apparent inability to cope with financial management and time constraints due to family commitments. The introduction of Equal Opportunity legislation and related programmes has assisted this process, but as my research shows the under-representation of women in principalship in proportion to the numbers of women teachers in Catholic Education still remains. This thesis examines the phenomenon in three dioceses in three Australian states. I have investigated this problem using a feminist research approach which is characterised by an emphasis on the significance of everyday life. Statistical material as to percentages of teachers in comparison with percentages of female principals was collected; dates of formulation and acceptance of relevant policies at diocesan levels were checked and questionnaires compiled. The questionnaires were distributed to appropriate stakeholders. Following the compilation of data from the questionnaires, themes emerged which provided the initial questions for focus groups made up of male and female principals and potential principals. These focus groups were then conducted in all three dioceses. Through all stages I carried out cross-referencing with my own journal sentries (Power, 1993—1999) . The qualitative and quantitative data generated from the focus groups was examined and analysed drawing on feminist concepts. I have found two major features emerging from the materials that I have generated. The first was the unpredictable, ambiguous and often contradictory relations that occur within Catholic Education, and how they were experienced by lay women. This aspect gave rise to the title of my thesis: 'Dancing on a Moving Floor' as many women felt the rules changed the closer they got to achieving principalship. Then both male and female participants highlighted 'male advantage' in terms that have been identified in other education systems, but this factor emerged as being further heightened in Catholic Education and occurring at systemic, organisational and individual levels. I have made a number of policy recommendations that could possibly change attitudes and practices for each of these levels. I conclude with some suggestions for further research.

Fuzzy concepts and formal methods

It has been recognised that formal methods are useful as a modelling tool in requirements engineering. Specification languages such as Z permit the precise and unambiguous modelling of system properties and behaviour. However some system problems, particularly those drawn from the information systems problem domain, may be difficult to model in crisp or precise terms. It may also be desirable that formal modelling should commence as early as possible, even when our understanding of parts of the problem domain is only approximate. This thesis suggests fuzzy set theory as a possible representation scheme for this imprecision or approximation. A fuzzy logic toolkit that defines the operators, measures and modifiers necessary for the manipulation of fuzzy sets and relations is developed. The toolkit contains a detailed set of laws that demonstrate the properties of the definitions when applied to partial set membership. It also provides a set of laws that establishes an isomorphism between the toolkit notation and that of conventional Z when applied to boolean sets and relations. The thesis also illustrates how the fuzzy logic toolkit can be applied in the problem domains of interest. Several examples are presented and discussed including the representation of imprecise concepts as fuzzy sets and relations, system requirements as a series of linguistically quantified propositions, the modelling of conflict and agreement in terms of fuzzy sets and the partial specification of a fuzzy expert system. The thesis concludes with a consideration of potential areas for future research arising from the work presented here.

Doctoral research and scholarly communication : candidates, supervisors and information literacy

This study investigates information literacy and scholarly communication within the processes of doctoral research and supervision at a distance. Both doctoral candidates and supervisors acknowledge information literacy deficiencies and it is suggested that disintermediation and the proliferation of information may contribute to those deficiencies. Further to this, the influence of pedagogic continuity—particularly in relation to the information seeking behaviour of candidates—is investigated, as is the concomitant aspect of how doctoral researchers practise scholarly communication. The well-documented and enduring problem for candidates of isolation from the research cultures of their universities is also scrutinised. The contentious issue of more formally involving librarians in the doctoral process is also considered, from the perspective of candidates and supervisors. Superimposed upon these topical and timely issues is the theoretical framework of adult learning theory, in particular the tenets of andragogy. The pedagogical-andragogical orientation of candidates and supervisors is established, demonstrating both the differences and similarities between candidates and supervisors, as are a number of independent variables, including a comparison of on-campus and off-campus candidates. Other independent variables include age, gender, DETYA (Department of Education, Training & Youth Affairs) category, enrolment type, stage of candidature, employment and status, type of doctorate, and English/non-English speaking background. The research methodology uses qualitative and quantitative techniques encompassing both data and methodological triangulation. The study uses two sets of questionnaires and a series of in-depth interviews with a sample of on-campus and off-campus doctoral candidates and supervisors from four Australian universities. Major findings include NESB candidates being more pedagogical than their ESB counterparts, and candidates and supervisors from the Sciences are more pedagogical than those from Arts, Humanities and Social Sciences, or Education. Candidates make a transition from a more dependent and pedagogically oriented approach to learning towards more of an independent and andragogical orientation over the duration of their candidature. However, over tune both on-campus and off-campus candidates become more isolated from the research cultures of their universities, and less happy with support received from their supervisors in relation to their literature reviews. Ill The study found large discrepancies in perception between the support supervisors believed they gave to candidates in relation to the literature review, and the support candidates believed they received. Information seeking becomes easier over time, but candidates face a dilemma with the proliferation of information, suggesting that disintermediation has exacerbated the challenges of evaluation and organisation of information. The concept of pedagogic continuity was recognised by supervisors and especially candidates, both negative and positive influences. The findings are critically analysed and synthesised using the metaphor of a scholarly 'Club' of which obtaining a doctorate is a rite of passage. Recommendations are made for changes in professional practice, and topics that may warrant further research are suggested.

Geelong community's priorities and expectations of public health care

Abstract This thesis set out to achieve the following objectives: (1) To identify the priorities and expectations that the Geelong community has of its public health care system. (2) To determine if there is a common view on the attributes of a just health system. (3) To consider a method of utilising the data in the determination of health care priority setting in Barwon Health. (4) To determine a model of community participation which enables ongoing input into the decision making processes of Barwon Health. The methodology involved a combination of qualitative and quantitative research. The qualitative work involved the use of focus groups that were conducted with 64 members of the Geelong community. The issues raised informed the development of the interview schedule that was the basis of the quantitative study, which surveyed a representative sample of 400 members of the Geelong community. Prior to reporting on this work, the areas of distributive justice, scarcity and community participation in health care were considered. The research found that timely access to public hospitals, emergency care and aged care services were the major priorities; for many people, the cost was less relevant than a quality service. Shorter waiting times and increased staffing levels were strongly supported. Increased taxes were nominated as the best means of financing the health system they sought. Community based services were less relevant than hospital services but health education was supported. An egalitarian approach to resource distribution was favoured although the community was prepared to discriminate in favour of younger people and against older people. There was strong support for the community to be involved in decision making in the public health care system through surveys or focus groups but very little support was given to priorities being determined by politicians, administrators and to a lesser extent, medical professionals.

Procedural justice and Australian environment : the case of the Wonthaggi water desalination plant

Drier conditions in Australia have compelled governments to implement various projects to address current or impending water shortages. Such projects have not always been popular with the local community who are directly affected by this infrastructure, with 'procedural justice' emerging as a critical issue. This paper analyses issues of public perceptions of 'procedural justice' in implementing environmental projects in regional areas, in the context of the recently approved desalination plant in the regional Victorian town of Wonthaggi. Drawing on both qualitative and quantitative data from a survey of 316 Wonthaggi residents, we show that one of the major predictors of residents' resistance toward accepting the building of the desalination plant was explained by perceptions of procedural injustice. We further argue that inadequate attention to the particular political history of the region has compounded the sense that the plant implementation has been unfair. Attention to such political histories is vital to avoiding conflict with local stakeholders and to the successful and ethical implementation of development projects in regional areas.