Improving the communication between care providers of individuals who may require joint replacement surgery (JRS) a framework for referral

Aims & rationale/Objectives : The objective of the project was to specify the information required in referrals to public hospital orthopaedic outpatient departments in order to streamline the care and prioritisation of individuals who may require JRS. It was envisaged that an evidence-based GP-Orthopaedic derived referral system would assist in ensuring that the right person accessed the right care at the right time.

Methods : In collaboration with the RACGP and the Commonwealth Department of Health and Ageing, a national stakeholder working group was convened. A scoping document was prepared with input from key stakeholders. A review of primary research was undertaken as well as a review of relevant guidelines. Information on the implementation and evaluation of similar programs in Australia and overseas also informed the referral specification.

Principal findings : The initial scoping processes with key stakeholders provided clear information on core components of the referral. These were the use of standardised and respected assessment tools to determine the severity of arthritis, fitness for surgery and willingness of affected individuals to undergo surgery.

Discussion : About 20,000 JRS occur each year in public hospitals which emanate from 5 to 10 fold number of referrals. Arthritis and musculoskeletal diseases are a national health priority area reflecting the high burden of disease associated with these conditions. Various initiatives are being undertaken to address the quality of life of affected individuals. This project has revealed areas of potential improvement in the communication between care providers of individuals who may need JRS.

Implications : The project will result in the development of a standard referral form and guidelines to assist referring practitioners to communicate more effectively with the multidisciplinary care team, in particular orthopaedic care providers. The guidelines will be piloted in a large rural setting.

ACE-Obesity : priority setting for obesity prevention

The ACE-Obesity study uses an evidence-based approach to evaluate interventions aimed at reducing the prevalence of obesity in Australian youth. It informs decision-makers about the benefits of individual interventions and the packaging of a coherent strategy for obesity prevention and management. To avoid methodological confounding, the approach employs standardised methods including a two stage concept of benefit; a common comparator, setting and decision context; Australian data; and extensive probabilistic uncertainty testing. The technical cost-effectiveness results (cost per DALY) for each of the selected interventions will be reported. Modelling is undertaken to convert changes in behaviour to BMI outcomes and then to DALYs, and issues of the attribution of costs across multiple objectives arise. Due process is achieved by involving stakeholders on a Working Group, and by consideration of second stage filters (such as equity, acceptability and feasibility). The results are brought together in a 'league table' in which all the interventions are ranked in order of economic merit without the usual methodological concerns about results drawn from studies lacking in comparability. In packaging interventions to meet particular budget allocations, the divisibility, mutual exclusivity and returns to scale of individual interventions are considered, as well as issues of program logic, target group coverage and a range of settings.

Improving the coordination of care for low back pain patients by creating better links between acute and community services

This paper reports on the development of a care-pathway to improve service linkages between the acute setting and community health services in the treatment of low back pain. The pathway was informed by two processes: (1) a literature review based on best-practice guidelines in the assessment, treatment and continuity of care for low back pain patients; and (2) consultation with staff and key stakeholders. Stakeholders from both the acute and community sectors comprised the Working Group, who identified central areas of concern to be addressed in the care-pathway, with the goal of preventing chronicity of low back pain and reducing emergency department presentations. The main outcomes achieved include: the development of a new care-coordinator role, which would support a greater focus on integration between acute and community sectors for low back pain patients; identifying the need to screen at-risk patients; implementation of the SCTT (Service Coordination Tool Templates) tool as a system of referral across the acute and community settings; and agreement on the need to develop an evidence-based self-management program to be offered to low back pain patients. The benefits and challenges of implementing this care pathway are discussed.

Black fella land – white fella tax : changing the CGT implications of aboriginal/native title

The taxation of aboriginal/native title payments gives rise to a number of complex and difficult legal and policy issues. Reform measures announced on 13 February 1998 by the then Federal Treasurer and Attorney-General did not address the possible capital gains tax (‘CGT’) implications and even those relating to ordinary income under s 6-5 Income Tax Assessment Act 1997 (Cth) remain unimplemented. The much anticipated Report of the Native Title Payments Working group (6 February 2009), while primarily focusing on non-taxation issues, also recognises the need for taxation reform and makes some recommendations in regard to such. Most recently, on 18 May the Assistant Treasurer, Senator Nick Sherry, the Minister for Families, Housing, Community Services and Indigenous Affairs, Jenny Macklin, and the Attorney General, Robert McClelland, announced the commencement of a national consultation on the tax treatment of native title, including the interaction of native title, Indigenous economic development and the tax system. The Assistant Treasurer recognised the need for “greater clarity and increased certainty for native title holders on how the tax system and native title interact.” At the same time, they released a paper entitled Native Title, Indigenous Economic Development and Tax to guide the national consultation. The proposed measures considered in the paper, including exempting Native title payments and/or creating a new tax exempt Indigenous Community Fund, provide a welcome step towards reform in this area. This article is part of a broader research project that explores the CGT implications of aboriginal/native title. While these provisions impact on both Indigenous traditional owners and relevant payers, such as mining companies, the focus in the project is particularly on the CGT implications for the traditional owners. This first part of the project examines the status of aboriginal/native title and incidental/ ancillary rights as CGT assets. The broader research project will then build on this analysis in the context of relevant CGT events. As the preliminary findings in this article evidence the CGT implications of aboriginal/native title are far from certain. The application of CGT to aboriginal/native title raises more issues than it answers. The key reason is that the current law is entirely unsuitable to communally held inalienable aboriginal/native title. Nevertheless, it will be seen that it is arguable that aboriginal/native title and/or incidental rights are post-CGT assets and acts in relation to such could trigger a CGT event with tax implications for the traditional owners. It will be suggested that these current tax provisions provide a very pertinent example where the law operates as a blunt tool that does not appropriately promote justice and reconciliation. To tax Indigenous communities as a result of acts that extinguish or impair their traditional ownership is incongruous. A specific provision(s) should be included in the capital gains provisions to ensure any such payments are exempt from taxation. This is not only fair given the history of uncompensated extinguishment of aboriginal title Australia, but also promotes the ability of Indigenous communities to optimise the financial benefits stemming from aboriginal/native title agreements.

Enriching student experience and inter-professional learning of inclusive design with Second Life

This position paper reflects rapid advances in immersive 2D and 3D eLearning technologies and the expanding pool of ideas and applications in higher education across two professions. Inspiration has been drawn from examples in design learning, and various multidisciplinary collaborative projects through developmental research in Multi-User Virtual Environments (MUVEs). Linden Lab's Second Life (SL) is the most mature and popular of the ‘persistent’ virtual worlds. The study described in this paper aims to increase the authenticity of student learning through a range of SL simulated ‘life experiences’ relating to accessibility and mobility in the built environment. Significantly, the successes of such initiatives lie in several elements: teaching champions with vision and courage; detailed scripting of precise role-play encounters for first-time users to provide supportive ‘blended learning’ contexts; careful and vigilant strategic management of facilities and resources, and a robust design program. This paper focuses on the crucial alignment of these elements to the specific challenges of designing and navigating conception and development processes, to enable the execution and delivery of a tightly defined script for meaningful and memorable learning outcomes. This innovative pedagogical approach lacks time-tested outcomes, but is recognised equally as opportunity and challenge; risk and reward.

Paving pathways : shaping the public health workforce through tertiary education

Public health educational pathways in Australia have traditionally been the province of Universities, with the Master of Public Health (MPH) recognised as the flagship professional entry program. Public health education also occurs within the fellowship training of the Faculty of Public Health Medicine, but within Australia this remains confined to medical graduates. In recent years, however, we have seen a proliferation of undergraduate degrees as well as an increasing public health presence in the Vocational Education and Training (VET) sector. Following the 2007 Australian Federal election, the new Labour government brought with it a refreshing commitment to a more inclusive and strategic style of government. An important example of this was the 2020 visioning process that identified key issues of public health concern, including an acknowledgment that it was unacceptable to allocate less than 2% of the health budget towards disease prevention. This led to the recommendation for the establishment of a national preventive health agency (Australia: the healthiest country by 2020 National Preventative Health Strategy, Prepared by the Preventative Health Taskforce 2009). The focus on disease prevention places a spotlight on the workforce that will be required to deliver the new investment in health prevention, and also on the role of public health education in developing and upskilling the workforce. It is therefore timely to reflect on trends, challenges and opportunities from a tertiary sector perspective. Is it more desirable to focus education efforts on selected lead issues such as the “obesity epidemic”, climate change, Indigenous health and so on, or on the underlying theory and skills that build a flexible workforce capable of responding to a range of health challenges? Or should we aspire to both? This paper presents some of the key discussion points from 2008 - 2009 of the Public Health Educational Pathways workshops and working group of the Australian Network of Public Health Institutions. We highlight some of the competing tensions in public health tertiary education, their impact on public health training programs, and the educational pathways that are needed to grow, shape and prepare the public health workforce for future

Through the looking glass : immersive interfaces for participant engagement in blended e-learning environments

This chapter outlines current research profiling students and educators participating in and constructing immersive interfaces in blended e-learning settings. Multi User Virtual Environments (MUVEs) and real world settings augmented with virtual information can generate problem-solving communities where participants gain greater technical knowledge and skills through meaningful and frequent interaction. MUVEs can also generate technical innovation amongst students from diverse disciplinary backgrounds provided students are encouraged to help each other and learn together. After detailing some false assumptions about computer literacy that can stifle meaningful exploration with new technologies in contemporary education, this chapter documents an exemplar involving extensive collaboration between students from different educational backgrounds with diverse technical competencies. The success of this initiative hinges on the willingness of educators to provide a shared learning experience where technology is used to facilitate increased student communication and offers a site for invention, informed critique, industry participation, and a sense of community.

Identifying annotations for adventure game generation from fiction text

Recent advancements in Text-to-Scene research have lead to the development of systems which automatically extract key concepts from the text of a fiction book and generate computer animated movies depicting the story. Extracting such annotations from raw fiction text is a laborious process and so in this work we evaluate appropriate candidates to serve as the basis for the required annotations for generating interactive virtual worlds.

We validate our choice by generating adventure games: inter-active virtual worlds which create a stylized representation of the environment described in the text, populate it with characters related to the story and define game goals related to the plot of the fiction story. Our prototype produces a fully playable game, making use of an existing open-source game engine.

The process is evaluated using user tests in which participants are asked to measure the accuracy with which the game represents the events, characters and goals described in the story. The response indicates that the chosen annotation set is sufficient to define a game that is a plausibly acceptable representation of the text.

Introduction to section 4

The nature and extent of the implementation of digital technology in mathematics curricula along with issues of access and equity were the issues considered by one working group of this ICMI study. A summary of the discussion conducted by the working group and the findings reported in the following chapters on this theme are presented. It is clear that widespread and sustained use of digital technology is not common and that where digital technology is used there are complex and confounding equity issues.

In what ways does policy on academic integrity, copyright and privacy need to respond in order to accommodate assessment with Web 2.0 tools?

Increasingly social web technologies, such as blogging and micro-blogging, audio and video podcasting, photo/video, social bookmarking, social networking, wiki writing or virtual worlds are being used as forms of authoring or content creation to support students’ learning in higher education. As Web 2.0 teaching practice is characterised by open access to information and collaborative networks there are both familiar and novel challenges for policy-makers in higher education institutions. The Government 2.0 Taskforce heralded legislative and practice changes necessary because of Web 2.0. We reflect on the qualitative feedback received from innovative higher education practitioners using Web 2.0 to assess student work. This indicates a need for information policy review to accommodate the cultural shift towards information exchange and communication across traditional institutional boundaries. Issues involved when implementing Web 2.0 assessments are identified to highlight requisite areas for policy improvement in higher education, in particular for academic integrity, copyright and privacy policies

Generation of 3D sparse feature models using multiple stereo views

Augmented Reality (AR) renders virtual information onto objects in the real world. This new user interface paradigm presents a seamless blend of the virtual and real, where the convergence of the two is difficult to discern. However, errors in the registration of the real and virtual worlds are common and often destroy the AR illusion. To achieve accurate and efficient registration, the pose of real objects must be resolved in a quick and precise manner.

Magával ragadó interfészek Art Education tanítás és tanulás vegyes valóság virtuális és valós környezetben

How selected next generation technologies support collaborative participation between higher education students and educators within a virtual socially networked e-learning landscape and encourage the interaction of communities of learners in multiple modes, ranging from text and images accessed within the Deakin Studies Online learning management system to a constructed virtual world in which the user’s creative imagination transports them to the “other side” of their computer screens is discussed in this paper. These constructed environments enable multiple simultaneous participants to access graphically built 3D environments, interact with digital artifacts and various functional tools and represent themselves through avatars, to communicate with other participants and engage in collaborative art learning.

Parallax

Parallax is a live contemporary dance work that incorporates 3D animation, stereoscopic illusions and dance. This work was performed within the Melbourne Fringe Festival at the Substation, Newport. Within this work the stereoscopic illusion creates a new choreographic palette that can be used to manipulate human physicality via animated bodies that appear within the performance space. The stereoscopic image is released from the wall and placed within the dancing environment the image becomes another body within the dance space that can be manipulated in ways that would be impossible for a real physical body. In turn, the dancing body is positioned within the digital environment. The performer’s abilities have not changed, but the space around the dancer can be manipulated with imagery that transforms the place of the dancer within time and space. The stereoscopic illusion and live dance are melded creating a new experience of choreography one that takes the infinite possibilities of 3D animation and places them directly within choreography. Thematically this performance draws on the historical events revolving around the development of the stereoscope in the 1830s and the seminal ideas of the virtual that surfaced at this time. In the early 1830s Charles Wheatstone drew on the ideas and writings of Euclid and Leonardo da Vinci and discovered binocular vision through the use of his stereoscope box. It was this box that became the entertainment sensation of this time becoming a standard parlour entertainment. Unlike now where imagery of people are everywhere in the 1830s these types of imagery were novel. The stereoscopic pictures often showed content of people doing ordinary tasks such as chopping wood, doing the washing or simply standing in front of their house. In Parallax a Victorian woman is transported from her hallway to virtual worlds where she encounters, Euclid’s ancient Greek column, a di Vinci sphere and one of the first stereoscopic images drawn by Charles Wheatstone’s a stick figure cube.