Exploring ways to better manage substance abuse issues

- Historically by default we have created an operational environment where the key AOD issue has been testing and not safety, behaviour and culture. - The tail wagging the dog. - We risk loosing the point the point. - Many people traditionally want to hear a paper about, testing, technology or the pros and cons of saliva VS urine testing etc . - This is a good example of how the workplace alcohol and other drugs area has been politicised, commercialised, simplified and myopic.

Coping with aggressive driving : driver accounts of how they manage themselves and others to reduce conflict on the road

Dealing with the aggression of other drivers on the road is an important skill given that driving is a common activity for adults in highly motorised countries. Even though incidents of extreme aggression on the road (such as assault) are reportedly rare, milder forms, some of them dangerous (such as tailgating or deliberately following too closely) are apparently common, and may be increasing. At the very least, this is likely to render the driving environment more stressful, and at worst elevates the risk of crashing by increasing both the level of risky driving behaviours and the likelihood of responses that escalate the situation. Thus the need for drivers to manage incidents of conflict is likely to become increasingly important. However, little research examines how drivers manage their own or others’ aggressive driving behaviour. Recently greater attention has been paid to driver cognitions, especially the attributions that drivers make about other drivers, that then might influence their own driving responses, particularly aggressive or risky ones. The study reported below was the first in a larger exploration of aggressive driving that focussed on driver cognitions, emotions and underlying motivations for aggressive behaviours on the road. Qualitative, in-depth interviews of drivers (n = 30, aged 18-49 years) were subjected to thematic analysis to investigate driver experiences with aggressive driving. Two main themes were identified from these accounts: driver management of self; and driver attempts to influence or manage other drivers. This paper describes the subthemes falling under the management of self main theme. These subthemes were labelled ‘being magnanimous’, ‘chilling out’, ‘slowing down’, and ‘apology/acknowledgment’. ‘Being magnanimous’ referred to situations where the respondent perceived him/herself to be a recipient of another’s aggressive driving and made a deliberate choice not to respond. However, a characteristic of this sub-theme was that this choice was underpinned by the adoption of morally superior stance, or sense of magnanimity. ‘Chilling out’ was a more general response to both the milder aggressive behaviours of other drivers and the general frustrations of driving. ‘Slowing down’ referred to reducing one’s speed in response to the perceived aggressive driving, often tailgating, of another. This subtheme appeared to consist of two separate underlying motivations. One of these was a genuine concern for one’s own safety while the other was more aimed at “getting back” at the other driver. ‘Apology’ referred to how drivers modified their more negative reactions and responses when another driver made gestures that acknowledged their having made a mistake, indicated an apology, or acknowledged the recipient driver. These sub-themes are discussed in relation to their implications for understanding aggressive driving and intervening to reduce it.

Attitudes and expectations of technologies to manage high risk wandering and elopement in persons with dementia : an Australian perspective

Wandering is aimless and repetitive locomotion that may expose persons with dementia (PWD) to elopement, getting lost and death. This study is an Australian replication of a US study. Cross-disciplinary consensus- based analysis was applied to data from five focus groups (N =47: cognitively intact LTC residents (5), carers of PWD (11), home care workers (13) allied health professionals and health-focused engineers (7) and RNs (11). Groups received briefing about wandering monitoring and elopement management systems. Consistent with US attitudes, participants in all groups agreed on what a wandering technology should do, how it should do it, and necessary technical specifications. Within each group participants raised the need for a continuum of care for PWD and the imperative for early recognition of potentially dangerous wandering and getting lost when they occur. Global Positioning System elopement management was the preferred option. Interestingly, the prospective value of GPS to recover a lost or eloped wanderer far outweighed privacy concerns, as in the US. A pervasive theme was that technologies need to augment, but cannot replace, attentive, compassionate caregiver presence. A significant theme raised only by Australian carers of PWD was the potential for development of implantable GPS technologies and the need for public debate about attendant ethical issues. Given that 60% or more of over 200,000 Australians and 4.5 million Americans with dementia will develop wandering, there is a pressing need to develop effective locator systems that may delay institutionalization, help allay carer concern and enhance PWD safety.

How do Australasian hospitals identify and manage malnutrition in their acute care wards?

One aim of the Australasian Nutrition Care Day Survey was to explore nutrition care practices in acute care hospital wards across Australia and New Zealand. Managers of Dietetic departments completed a questionnaire regarding ward nutrition care practices. Overall, 370 wards from 56 hospitals participated. The median ward size was 28 beds (range: 8–60 beds). Although there was a wide variation in full-time equivalent availability of dietitians (median: 0.3; range: 0–1.4), their involvement in providing nutrition care across ward specialities was signifi cantly higher than other staff members (χ2, p < 0.01). Feeding assistance, available in 89% of the wards, was provided mainly by nursing staff and family members (χ2, p < 0.01). Protected meal times were implemented in 5% (n = 18) of the wards. Fifty-three percent of the wards (n = 192) weighed patients on request and 40% (n = 148) on admission. Routine malnutrition screening was conducted in 63% (n = 232) of the wards and 79% (n = 184) of these wards used the Malnutrition Screening Tool, 16% (n = 37) the Malnutrition Universal Screening Tool, and 5% (n = 11) other tools. Nutrition rescreening was routinely conducted in 20% of the wards. Among wards that implemented nutrition screening, 41% (n = 100) routinely referred patients “at risk” of malnutrition to dietitians as part of their standard protocol for malnutrition management. Results of this study provide new knowledge regarding current nutrition care practice, highlight gaps in existing practice, and can be used to inform improved nutrition care in acute care wards across Australia and New Zealand.

Facilitating lifestyle changes to manage menopausal symptoms in women with breast cancer : delivering the Pink Women’s Wellness Program

Women diagnosed as having breast cancer may experience difficulties with posttreatment effects such as menopausal symptoms. The aims of this pilot study were to (1) evaluate the impact of a multimodal lifestyle program on reducing menopausal symptoms in women with breast cancer and (2) examine the impact of the program on health-related quality of life (HRQoL) and adherence to lifestyle recommendations.

Planning to Manage My Teaching in a Democratic Classroom

Preservice teachers consistently report that managing student behaviour is one of their major concerns prior to and during practicum (Capel, 1997; Kyriacou & Stephens, 1999). Not surprisingly, preservice teachers are keen to gain knowledge and understanding of effective classroom management approaches that facilitate the development of positive learning environments in which students are engaged in learning. Establishing democratic teaching practices that allow student choice, communicating in a positive, helpful manner, ensuring the right to teach and the right to learn without disruptions is upheld, and promoting self-discipline are important steps in preventing misbehavior and developing a democratic community of learners.

How to meet stakeholders' expectations, not manage them?

Evaluation practices in the higher education sector have been criticised for having unclear purpose and principles; ignoring the complexity and changing nature of learning and teaching and the environments in which they occur; relying almost exclusively on student ratings of teachers working in classroom settings; lacking reliability and validity; using data for inappropriate purposes; and focusing on accountability and marketing rather than the improvement of learning and teaching. In response to similar criticism from stakeholders, in 2011 Queensland University of Technology began a project, entitled REFRAME, to review its approach to evaluation, particularly the student survey system it had been using for the past five years. This presentation will outline the scholarly, evidence based methodology used to undertake institution-wide change, meet the needs of stakeholders suitable to the cultural needs of the institution. It is believed that this approach is broadly applicable to other institutions contemplating change with regard to evaluation of learning and teaching.

Using strategically applied grazing to manage invasive alien plants in novel grasslands

Introduction Novel ecosystems that contain new combinations of invasive alien plants (IAPs) present a challenge for managers. Yet, control strategies that focus on the removal of the invasive species and/or restoring historical disturbance regimes often do not provide the best outcome for long-term control of IAPs and the promotion of more desirable plant species. Methods This study seeks to identify the primary drivers of grassland invasion to then inform management practices toward the restoration of native ecosystems. By revisiting both published and unpublished data from experiments and case studies within mainly an Australian context for native grassland management, we show how alternative states models can help to design control strategies to manage undesirable IAPs by manipulating grazing pressure. Results Ungulate grazing is generally considered antithetical to invasive species management because in many countries where livestock production is a relatively new disturbance to grasslands (such as in Australia and New Zealand as well as Canada and the USA), selective grazing pressure may have facilitated opportunities for IAPs to establish. We find that grazing stock can be used to manipulate species composition in favour of the desirable components in pastures, but whether grazing is rested or strategically applied depends on the management goal, sizes of populations of the IAP and more desirable species, and climatic and edaphic conditions. Conclusions Based on our findings, we integrated these relationships to develop a testable framework for managing IAPs with strategic grazing that considers both the current state of the plant community and the desired future state—i.e. the application of the principles behind reclamation, rehabilitation, restoration or all three—over time.

Teaching pharmacy students how to manage effectively in a highly competitive environment

Aims To evaluate if a revamped business management course for 4th year undergraduate pharmacy students had achieved the course aims of not only improving pharmacy students’ perceived understanding of pharmacy business management topics but also increasing their confidence in their business management knowledge and skills. Background Student feedback from previous years had indicated that the cohort had struggled to translate theoretical business management concepts learned in the classroom into practice in the workplace. To address this problem the course has been changed to a ‘flipped classroom’ format with face-to-face time focusing on case-based scenarios and interactive classroom discussion with some role plays. Method Both course assessment throughout the semester and a student survey informed the evaluation process. Results After completing the course, students felt they had increased their knowledge of business management concepts but many indicated that they lacked the confidence to undertake basic management functions. Conclusions Further course restructuring is required with a greater focus on skills development.

Systematic review of pharmacologic and non-pharmacologic interventions to manage cognitive alterations after chemotherapy for breast cancer

Purpose Cognitive alterations are reported in breast cancer patients receiving chemotherapy. This has adverse effects on patients’ quality of life and function. This systematic review investigates the effectiveness of pharmacologic and non-pharmacologic interventions to manage cognitive alterations associated with breast cancer treatment. Methods Medline via EBSCOhost, CINAHL and Cochrane CENTRAL were searched for the period January 1999 to May 2014 for prospective randomized controlled trials related to the management of chemotherapy-associated cognitive alterations. Included studies investigated the management of chemotherapy-associated cognitive alterations and used subjective or objective measures in patients with breast cancer during or after chemotherapy. Two authors independently extracted data and assessed the risk of bias. Results Thirteen studies involving 1138 participants were included. Overall, the risk of bias for the 13 studies were either high (n=11) or unclear (n=2). Pharmacologic interventions included psychostimulants (n=4), epoetin alfa (n=1), and Ginkgo biloba (n=1). Non-pharmacologic interventions were cognitive training (n=5) and physical activity (n=2). Pharmacologic agents were ineffective except for self-reported cognitive function in an epoetin alfa study. Cognitive training interventions demonstrated benefits in self-reported cognitive function, memory, verbal function and language and orientation/attention. Physical activity interventions were effective in improving executive function and self-reported concentration. Conclusion Current evidence does not favor the pharmacologic management of cognitive alterations associated with breast cancer treatment. Cognitive training and physical activity interventions appear promising, but additional studies are required to establish their efficacy. Further research is needed to overcome methodological shortfalls such as heterogeneity in participant characteristics and non-standardized neuropsychological outcome measures.

Facilitating lifestyle changes to manage menopausal symptoms in women with breast cancer: A randomized controlled pilot trial of The Pink Women’s Wellness Program

OBJECTIVE Women diagnosed as having breast cancer may experience difficulties with posttreatment effects such as menopausal symptoms. The aims of this pilot study were to (1) evaluate the impact of a multimodal lifestyle program on reducing menopausal symptoms in women with breast cancer and (2) examine the impact of the program on health-related quality of life (HRQoL) and adherence to lifestyle recommendations. METHODS Overall, 55 women aged 45 to 60 years with one moderate to severe menopausal symptom and a history of breast cancer were randomized into an intervention group (n = 26) or a control group (n = 29). Women in the intervention group received a lifestyle intervention (The Pink Women’s Wellness Program) that included clinical consultations and a tailored health education program. Measurements of menopausal symptoms (Greene Climacteric Scale), HRQoL (SF-12 and Functional Assessment of Cancer Therapy—Breast), and modifiable lifestyle factors (food intake, physical activity, smoking and alcohol use, and sleep disturbance) were taken at baseline and 12 weeks. RESULTS Women in the intervention group reported clinically significant reductions in many menopausal symptoms, specifically somatic symptoms (d = 0.52), vasomotor symptoms (d = 0.55), sexual dysfunction (d = .65), and overall menopausal symptoms (d = 0.54), at 12 weeks compared with the control group (d = 0.03, d = 0.24, d = 0.18, and d = 0.05, respectively). Women in the intervention group reported improvements in Functional Assessment of Cancer Therapy—Breast subscale scores, physical well-being and functional well-being, and Functional Assessment of Cancer Therapy—General total scores (intervention group: d = 0.54, d = 0.50, and d = 0.48, respectively; control group: d = 0.22, d = 0.11, and d = 0.05, respectively). CONCLUSIONS The Pink Women’s Wellness Program is effective in decreasing menopausal symptoms, thus improving HRQoL. This being a pilot study, further research is recommended to investigate the benefits of combining nonpharmacological interventions for women with breast cancer to reduce their treatment-related menopausal symptoms.

Using law to identify, manage and prevent child maltreatment

This chapter identifies ways in which laws are capable of responding to child maltreatment, both as an immediate regulator of conduct, and as an influence on a society’s cultural development and approach to children’s welfare. Informed by practices and experiences in selected common law systems, the chapter provides examples of legal mechanisms that can inform discussion of optimal strategies to identify and manage child maltreatment in many different societies. Both positive and negative aspects of these mechanisms are noted. While controversies arise as to what kinds of laws are best in preventing and responding to child maltreatment, and even, more fundamentally, whether there is a role for law in protecting children, this chapter offers evidence that a variety of legal tools can be employed to address child abuse and neglect, for any cultural setting in which there is willingness to act to prevent and treat its various forms.