An observational study of health professionals’ use of evidence to inform the development of clinical management tools

Aim. This observational study sought to investigate the process of evidence use by health professionals during development of evidence-based clinical management tools.

Background. Studies conducted to explore the process of research use are scarce and knowledge of this process is essential for our understanding of the influences on research use in practice.

Design. A qualitative, non-participant, observational design.

Methods. Behaviour and actions of two separate multidisciplinary teams were observed and audio-recorded during a combined total of seven meetings for the development of clinical management tools. Semi-structured, one-to-one interviews were conducted approximately half-way through the development process and following completion of the clinical management tools.

Results. Three major themes emerged from this research. First, the process of clinical management tool development and evidence use. Nurses assumed responsibility for coordination of development which focused on describing current practice. Second, the forms of evidence employed during the development process included the use of experiential knowledge, opinions and knowledge of the context, in addition to research evidence. However, reference to research evidence was limited and its incorporation into the instrument was infrequently observed. Third, the use of research evidence emerged with respect to how such evidence was employed.

Conclusion. This study focused on real-life discussion and decision-making that occurred between health professionals when developing evidence-based clinical management tools. Health professionals may have a tendency to rely on their professional experience and current practice in preference to seeking and applying relevant research evidence.

Relevance to clinical practice. Nurses have an important role to play in the development of multidisciplinary evidence-based clinical management tools, but to actively participate in this process they need to be familiar with the relevant research evidence and have the skills and confidence to integrate the evidence into practice.

Categorisation of knowledge management processes in the development of sustainable enterprises

Sustainable development is a growing area of interest in organisations. Particularly those that have large energy demands for processing, use dwindling raw materials or produce a great deal of waste through production. Knowing those processes that can contribute to making an organisation more sustainable provides a great advantage both in terms of project implementation success and in measurable Triple Bottom Line returns.

In previous research we identified that many of the Information Technology processes used to assist organisations in developing sustainable practices were more clearly suited as Knowledge Management processes (Van Der Meer and Sinnappan, 2008), however less empirical study has been done to categorise them meaningfully.

In this study we have taken these Knowledge Management processes and categorised them according to the sustainable development practice where we identify they can be of service based on Waage et al (2003). Through this we are hoping to develop a framework for organisations to determine what Knowledge Management processes are needed to achieve the particular sustainable development. We may also be able to judge what steps an organisation needs to take to develop further sustainable practices in other areas.

Development of a framework for knowledge management tools in sustainable development would assist industries in determining the best processes for these sustainable projects. This framework also contributes to the body of knowledge on sustainable development and Information Technology.

The Good Lives Model in practice : offence pathways and case management

During the past decade, the Good Lives Model of Offender Rehabilitation (GLM) has gained considerable momentum and popularity as a rehabilitation framework for forensic populations. The GLM is primarily applied by the treatment sector, however very recently, it has been used to generate a structured strengths based approach to case management. The purpose of this paper is multi-layered. First, we present the theory of the GLM, explaining its conceptual underpinnings and in addition, present the results of recent GLM empirical research that found two pathways to offending: direct and indirect. Next, we describe how the GLM conceptual underpinnings, together with the empirical research findings, translate into a structured and meaningful case management approach for community corrections. The process for effective case management of offenders using the GLM is outlined and further, two GLM case management tools are presented and their purpose and application to offender rehabilitation is briefly set out. Finally, we describe the necessary support factors that are vital to the integrity, success and sustainability of this case management approach.

Optimizing delivery of recovery-oriented online self-management strategies for bipolar disorder : a review

Self-management is emerging as a viable alternative to difficult-to-access psychosocial treatments for bipolar disorder (BD), and has particular relevance to recovery-related goals around empowerment and personal meaning. This review examines data and theory on BD self-management from a recovery-oriented perspective, with a particular focus on optimizing low-intensity delivery of self-management tools via the web.

Chronic disease self-management in Aboriginal communities : towards a sustainable program of care in rural communities

The Chronic Disease Self-Management (CDSM) strategy for Aboriginal patients on Eyre Peninsula, South Australia, was designed to develop and trial new program tools and processes for goal setting, behaviour change and self-management for Aboriginal people with diabetes. The project was established as a one-year demonstration project to test and trial a range of CDSM processes and procedures within Aboriginal communities and not as a formal research project. Over a one-year period, 60 Aboriginal people with type-2 diabetes in two remote regional centres participated in the pilot program. This represents around 25% of the known Aboriginal diabetic population in these sites. The project included training for four Aboriginal Health Workers in goal setting and self-management strategies in preparation for them to run the program. Patients completed a Diabetes Assessment Tool, a Quality of Life Questionnaire (SF12), the Work and Social Adjustment Scale (WASAS) at 0, 6 and 12 months. The evaluation tools were assessed and revised by consumers and health professionals during the trial to determine the most functional and acceptable processes for Aboriginal patients. Some limited biomedical data were also recorded although this was not the principal purpose of the project. Initial results from the COAG coordinated care trial in Eyre suggest that goal setting and monitoring processes, when modified to be culturally inclusive of Aboriginal people, can be effective strategies for improving self-management skills and health-related behaviours of patients with chronic illness. The CDSM pilot study in Aboriginal communities has led to further refinement of the tools and processes used in chronic illness self-management programs for Aboriginal people and to greater acceptance of these processes in the communities involved. Participation in a diabetes self-management program run by Aboriginal Health Workers assists patients to identify and understand their health problems and develop condition management goals and patient-centred solutions that can lead to improved health and wellbeing for participants. While the development of self-management tools and strategies led to some early indications of improvements in patient participation and resultant health outcomes, the pilot program and the refinement of new assessment tools used to assist this process has been the significant outcome of the project. The CDSM process described here is a valuable strategy for educating and supporting people with chronic conditions and in gaining their participation in programs designed to improve the way they manage their illness. Such work, and the subsequent health outcome research planned for rural regions, will contribute to the development of more comprehensive CDSM programs for Aboriginal communities generally.

Identifying knowledge gaps in seagrass research and management: An Australian perspective.

Seagrass species form important marine and estuarine habitats providing valuable ecosystem services and functions. Coastal zones that are increasingly impacted by anthropogenic development have experienced substantial declines in seagrass abundance around the world. Australia, which has some of the world's largest seagrass meadows and is home to over half of the known species, is not immune to these losses. In 1999 a review of seagrass ecosystems knowledge was conducted in Australia and strategic research priorities were developed to provide research direction for future studies and management. Subsequent rapid evolution of seagrass research and scientific methods has led to more than 70% of peer reviewed seagrass literature being produced since that time. A workshop was held as part of the Australian Marine Sciences Association conference in July 2015 in Geelong, Victoria, to update and redefine strategic priorities in seagrass research. Participants identified 40 research questions from 10 research fields (taxonomy and systematics, physiology, population biology, sediment biogeochemistry and microbiology, ecosystem function, faunal habitats, threats, rehabilitation and restoration, mapping and monitoring, management tools) as priorities for future research on Australian seagrasses. Progress in research will rely on advances in areas such as remote sensing, genomic tools, microsensors, computer modeling, and statistical analyses. A more interdisciplinary approach will be needed to facilitate greater understanding of the complex interactions among seagrasses and their environment.

Impacts and management of feral cats Felis catus in Australia

Feral cats are among the most damaging invasive species worldwide, and are implicated in many extinctions, especially in Australia, New Zealand and other islands. Understanding and reducing their impacts is a global conservation priority. We review knowledge about the impacts and management of feral cats in Australia, and identify priorities for research and management. In Australia, the most well understood and significant impact of feral cats is predation on threatened mammals. Other impacts include predation on other vertebrates, resource competition, and disease transmission, but knowledge of these impacts remains limited. Lethal control is the most common form of management, particularly via specifically designed poison baits. Non-lethal techniques include the management of fire, grazing, food, and trophic cascades. Managing interactions between these processes is key to success. Given limitations on the efficacy of feral cat management, conservation of threatened mammals has required the establishment of insurance populations on predator-free islands and in fenced mainland enclosures. Research and management priorities are to: prevent feral cats from driving threatened species to extinction; assess the efficacy of new management tools; trial options for control via ecosystem management; and increase the potential for native fauna to coexist with feral cats.

Managing shark fishermen in southern Australia : a critique

This paper analyses effects of a shift from input to output controls in Australia's Southern Shark Fishery. We show that the use of two management tools--individual transferable quotas and a "partnership approach"--was flawed and argue that primary contributing causes were the unjustified expectation that quota management would serve as a [`]technical fix' to a variety of presumed problems, the discounting of social effects and the extreme lack of stability in the organizational structure within which this fishery was situated.

Addressing aquaculture-fisheries interactions through the implementation of the ecosystem approach to aquaculture (EAA

This review addresses how the ecosystem approach to aquaculture (EAA) can optimize aquaculture-fisheries interactions considering different spatial scales from farm, aquaculture zone and watershed through to the global market. Aquaculture and fisheries are closely related subsectors with frequent interactions, largely due to the sharing of common ecosystems and natural resources. Interactions are also born from the flow of biomass from fisheries to aquaculture through fish-based feeds (e.g. fishmeal, fish oil and trashfish), through the collection of wild seed and brookstock, and genetic resources and biomass transfer from aquaculture to fisheries through culture-based fisheries (CBF) and escapees. Negative effects include modification of habitats affecting fisheries resources and activities (e.g. mangrove clearing for shrimp ponds, seabed disturbances through anchoring of aquaculture cages or pens, damage to seagrasses, alteration to reproductive habitats, biodiversity loss). Eutrophication of waterbodies due to excess nutrient release leading to anoxia and fish mortality can also impact negatively on biodiversity and wild fish stocks. Release of diseases and chemicals also imposes some threats on fisheries. Yet there could be beneficial impacts; for example, aquaculture is increasingly contributing to capture fisheries through CBF and could contribute to restore overfished stocks. Aquaculture can offer alternative livelihoods to fisherfolk, providing increased opportunity to them and also to their families, and especially to women. Aquaculture-increased production and marketing can also enhance and indirectly improve processing and market access to similar fishery products. The ecosystem approach to aquaculture (EAA) is a strategy for the management of the sector that emphasizes intersectoral complementarities by taking into account the interactions between all the activities within ecologically meaningful boundaries and acknowledging the multiple services provided by ecosystems. The main objective of this review is to understand the status of aquaculture-fisheries interactions associated with the biological, technological, social, economic, environmental, policy, legal and other aspects of aquaculture development and to analyze how these interactions are or could be addressed with an EAA. Therefore, the review involves aspects of scoping, identification of issues, prioritizing, devising management tools and plans for minimizing negative effects and optimizing positive ones within the context of social-ecological resilience, at different relevant geographical scales. Many of the management measures suggested in this review must involve not only EAA but also an ecosystem approach to fisheries (EAF), especially to deal with issues such as fishery of wild seed and the management of fisheries to produce fishmeal/oil for pelleted feeds or for direct feeding with wet fish. The implementation of EAA and EAF should help to overcome the sectoral and intergovernmental fragmentation of resource management efforts and assist in the development of institutional mechanisms and private-sector arrangements for effective coordination among various sectors active in ecosystems in which aquaculture and fisheries operate and between the various levels of government. Ecosystem-based management involves a transition from traditional sectoral planning and decision-making to the application of a more holistic approach to integrated natural resource management in an adaptive manner.

Internationalization of boost juice to Malaysia

This case describes the process that the Australian juice retail chain, Boost Juice, has used to internationalize to Malaysia. The main objective of this case is to demonstrate good practice in regard to internationalization. The case provides the background of the juice bar industry in Malaysia and determines that it is an attractive market for new start-up juice bars. An analysis of Boost Juice's capability determined that the company utilized the skills of its staff, product innovations, branding and marketing as core competencies to support its internationalization into Malaysia. In particular, the company's distinctive capabilities of organizational flexibility, management skill, brand and communication enabled it to convert these core competencies into competitive advantage and secure market share in Malaysia. The Boost Juice franchise process is analysed and the control and management tools that Boost Juice utilized to support its internationalization into Malaysia are identified. © 2014 World Scientific Publishing Co.

Identifying the location of fire refuges in wet forest ecosystems

The increasing frequency of large, high-severity fires threatens the survival of old-growth specialist fauna in fire-prone forests. Within topographically diverse montane forests, areas that experience less severe or fewer fires compared with those prevailing in the landscape may present unique resource opportunities enabling old-growth specialist fauna to survive. Statistical landscape models that identify the extent and distribution of potential fire refuges may assist land managers to incorporate these areas into relevant biodiversity conservation strategies. We used a case study in an Australian wet montane forest to establish how predictive fire simulation models can be interpreted as management tools to identify potential fire refuges. We examined the relationship between the probability of fire refuge occurrence as predicted by an existing fire refuge model and fire severity experienced during a large wildfire. We also examined the extent to which local fire severity was influenced by fire severity in the surrounding landscape. We used a combination of statistical approaches, including generalized linear modeling, variogram analysis, and receiver operating characteristics and area under the curve analysis (ROC AUC). We found that the amount of unburned habitat and the factors influencing the retention and location of fire refuges varied with fire conditions. Under extreme fire conditions, the distribution of fire refuges was limited to only extremely sheltered, fire-resistant regions of the landscape. During extreme fire conditions, fire severity patterns were largely determined by stochastic factors that could not be predicted by the model. When fire conditions were moderate, physical landscape properties appeared to mediate fire severity distribution. Our study demonstrates that land managers can employ predictive landscape fire models to identify the broader climatic and spatial domain within which fire refuges are likely to be present. It is essential that within these envelopes, forest is protected from logging, roads, and other developments so that the ecological processes related to the establishment and subsequent use of fire refuges are maintained.

Examining the functional role of current area closures used for the conservation of an overexploited and highly mobile fishery species

Protecting essential habitats through the implementation of area closures has been recognized as a useful management tool for rebuilding overfished populations and minimizing habitat degradation. School shark (Galeorhinus galeus) have suffered significant stock declines in Australia; however, recent stock assessments suggest the population may have stabilized and the protection of closed nursery areas has been identified as a key management strategy to rebuilding their numbers. Young-of-The-year (YOY) and juvenile G. galeus were acoustically tagged and monitored to determine ontogenetic differences in residency and seasonal use of an important protected nursery area (Shark Refuge Area or SRA) in southeastern Tasmania. BothYOYand juvenile G. galeus showed a distinct seasonal pattern of occurrence in the SRAwith most departing the area during winter and only a small proportion of YOY (33%) and no juveniles returning the following spring, suggesting areas outside the SRA may also be important during these early life-history stages. While these behaviors confirm SRAs continue to function as essential habitat during G. galeus early life history, evidence of YOY and juveniles emigrating from these areas within their first 1-2 years and the fact that few YOY return suggest that these areas may only afford protection for a more limited amount of time than previously thought. Determining the importance of neighbouring coastal waters and maintaining the use of traditional fisheries management tools are therefore required to ensure effective conservation of G. galeus during early life history.

An empirical study of user perceived usefulness and preference of open learner model visualisations

Many higher education institutions have reformed their academic programmes to adopt unit learning outcomes. It is essential for effective learning management tools to support this fundamental transformation. We see the need for a tool that provides visualisations of Open Learner Models (OLM) and associated e-portfolio content to guide students in achieving intended learning outcomes, help evidence their learning andkeep them engaged in their study. OLMs surface the relationship between learning activities and tasks, formative and summativeassessment, and intended learning outcomes. We have developedand validated a set of candidate visualisations for such OLMs. We report key findings from our study in terms of potential users’ feedback on our tool’s support for tracking learning progress against learning outcomes. Our findings can inform and refine learning management systems.

Manual on application of molecular tools in aquaculture and inland fisheries management. Part I : conceptual basis of population genetic approaches

The aim of this manual is to provide a comprehensive practical tool for the generation and analysis of genetic data for subsequent application in aquatic resources management in relation to genetic stock identification in inland fisheries and aquaculture. The material only covers general background on genetics in relation to aquaculture and fisheries resource management, the techniques and relevant methods of data analysis that are commonly used to address questions relating to genetic resource characterisation and population genetic analyses. No attempt is made to include applications of genetic improvement techniques e.g. selective breeding or producing genetically modified organisms (GMOs). The manual includes two ‘stand-alone’ parts, of which this is the first volume: Part 1 – Conceptual basis of population genetic approaches: will provide a basic foundation on genetics in general, and concepts of population genetics. Issues on the choices of molecular markers and project design are also discussed. Part 2 – Laboratory protocols, data management and analysis: will provide step-by-step protocols of the most commonly used molecular genetic techniques utilised in population genetics and systematic studies. In addition, a brief discussion and explanation of how these data are managed and analysed is also included. This manual is expected to enable NACA member country personnel to be trained to undertake molecular genetic studies in their own institutions, and as such is aimed at middle and higher level technical grades. The manual can also provide useful teaching material for specialised advanced level university courses in the region and postgraduate students. The manual has gone through two development/improvement stages. The initial material was tested at a regional workshop and at the second stage feedback from participants was used to improve the contents.