Addressing alcohol related harms within maxillofacial trauma practice

Background A brief intervention, conducted in the acute setting care setting after an alcohol-related injury, has been reported to be highly beneficial in reducing the risk of re-injury and in reducing subsequent level of alcohol consumption. This project aimed to understand Australasian Oral and Maxillofacial Surgeons' attitudes, knowledge and skills in terms of alcohol screening and brief intervention within acute settings for patients admitted with facial trauma. Materials and Methods A web-based survey was made available to all members (n=200-250) of the Australian and New Zealand Association of Oral and Maxillofacial Surgeons (ANZAOMS), promoted through a number of email bulletins sent by the Association to all members. Implied consent is assumed for participants who complete the online survey. The survey explored their current level of involvement in treating patients with alcohol-relatd facial trauma, as well as their knowledge of and attitudes towards alcohol screening and brief intervention. The survey also explored their willingness for further training and involvement in implementing a SBI program. Parts of the survey were based on a hypothetical case with facial injury and drinking history which was presented to the participants and the participants were asked to give their response to this scenario. Results A total of 58 surgeons completed the on-line survey. 91% of surgeons surveyed were males and 88% were consultant surgeons. 71% would take alcohol history; 29% would deliver a brief alcohol intervention and 14% would refer the patients to an alcohol treatment service or clinician. 40% agreed to have adequate training in managing patients with alcohol-related injuries, while 17% and 19% felt they had adequate time and resources. 76% of surgeons reported the need for more information on where to refer patients for appropriate alcohol treatment. Conclusion The study findings confirm the challenges and barriers to implementing brief alcohol intervention in current practice. There are service gaps that exist, as well as opportunities for training.

Degree of value alignment : a grounded theory of rural nurse resignations

INTRODUCTION: The shortage of nurses willing to work in rural Australian healthcare settings continues to worsen. Australian rural areas have a lower retention rate of nurses than metropolitan counterparts, with more remote communities experiencing an even higher turnover of nursing staff. When retention rates are lower, patient outcomes are known to be poorer. This article reports a study that sought to explore the reasons why registered nurses resign from rural hospitals in the state of New South Wales, Australia. METHODS: Using grounded theory methods, this study explored the reasons why registered nurses resigned from New South Wales rural hospitals. Data were collected from 12 participants using semi-structured interviews; each participant was a registered nurse who had resigned from a rural hospital. Nurses who had resigned due to retirement, relocation or maternity leave were excluded. Interviews were transcribed verbatim and imported into NVivo software. The constant comparative method of data collection and analysis was followed until a core category emerged. RESULTS: Nurses resigned from rural hospitals when their personal value of how nursing should occur conflicted with the hospital's organisational values driving the practice of nursing. These conflicting values led to a change in the degree of value alignment between the nurse and hospital. The degree of value alignment occurred in three dynamic stages that nurses moved through prior to resigning. The first stage, sharing values, was a time when a nurse and a hospital shared similar values. The second stage was conceding values where, due to perceived changes in a hospital's values, a nurse felt that patient care became compromised and this led to a divergence of values. The final stage was resigning, a stage where a nurse 'gave up' as they felt that their professional integrity was severely compromised. The findings revealed that when a nurse and organisational values were not aligned, conflict was created for a nurse about how they could perform nursing that aligned with their internalised professional values and integrity. Resignation occurred when nurses were unable to realign their personal values to changed organisational values - the organisational values changed due to rural area health service restructures, centralisation of budgets and resources, cumbersome hierarchies and management structures that inhibited communication and decision making, out-dated and ineffective operating systems, insufficient and inexperienced staff, bullying, and a lack of connectedness and shared vision. CONCLUSIONS: To fully comprehend rural nurse resignations, this study identified three stages that nurses move through prior to resignation. Effective retention strategies for the nursing workforce should address contributors to a decrease in value alignment and work towards encouraging the coalescence of nurses' and hospitals' values. It is imperative that strategies enable nurses to provide high quality patient care and promote a sense of connectedness and a shared vision between nurse and hospital. Senior managers need to have clear ways to articulate and imbue organisational values and be explicit in how these values accommodate nurses' values. Ward-level nurse managers have a significant responsibility to ensure that a hospital's values (both explicit and implicit) are incorporated into ward culture.

Teaching peer review reflective processes in accounting

A well designed peer review process in higher education subjects can lead to more confident and reflective learners who become skilled at making independent judgements of their own and others’ work; essential requirements for successful lifelong learning. The challenge for educators is to ensure their students gain these important graduate attributes within the constraints of a range of internal and external tensions currently facing higher education systems, including, respectively, the realities of large undergraduate Accounting subjects, culturally diverse and time-poor academics and students, and increased calls for public accountability of the Higher Education sector by groups such as the OECD. Innovative curriculum and assessment design and collaborative technologies have the capacity to simultaneously provide some measure of relief from these internal and external tensions and to position students as responsible partners in their own learning. This chapter reports on a two phase implementation of an online peer review process as part of the assessment in a large, under-graduate, International Accounting class. Phase One did not include explicit reflective strategies within the process, and anonymous and voluntary student views served to clearly highlight that students were ‘confused’ and ‘hesitant’ about moving away from their own ideas; often mistrusting the conflicting advice received from multiple peer reviewers. A significant number of students also felt that they did not have the skills to constructively review the work of their peers. Phase Two consequently utilised the combined power of e-Technology, peer review feedback and carefully scaffolded and supported reflective practices from Ryan and Ryan’s Teaching and Assessing Reflective Learning (TARL) model (see Chap. 2). Students found the reflective skills support workshop introduced in Phase Two to be highly useful in maximising the benefits of the peer review process, with 83 % reporting it supported them in writing peer reviews, while 90 % of the respondents reporting the workshop supported them in utilising peer and staff feedback.

Emotional experiences of preservice science teachers in online learning : the formation, disruption and maintenance of social bonds

The enactment of learning to become a science teacher in online mode is an emotionally charged experience. We attend to the formation, maintenance and disruption of social bonds experienced by online preservice science teachers as they shared their emotional online learning experiences through blogs, or e-motion diaries, in reaction to videos of face-to-face lessons. A multi-theoretic framework drawing on microsociological perspectives of emotion informed our hermeneutic interpretations of students’ first-person accounts reported through an e-motion diary. These accounts were analyzed through our own database of emotion labels constructed from the synthesis of existing literature on emotion across a range of fields of inquiry. Preservice science teachers felt included in the face-to-face group as they watched videos of classroom transactions. The strength of these feelings of social solidarity were dependent on the quality of the video recording. E-motion diaries provided a resource for interactions focused on shared emotional experiences leading to formation of social bonds and the alleviation of feelings of fear, trepidation and anxiety about becoming science teachers. We offer implications to inform practitioners who wish to improve feelings of inclusion amongst their online learners in science education.

Medical and nursing students perceived knowledge, attitudes, and practices concerning human immunodeficiency virus

Objective. To assess medical and nursing students’ knowledge, attitudes, and practices (KAP) regarding human immunodeficiency virus (HIV) in Fiji. Methods. A cross-sectional study of 275 medical and 252 nursing students that participated in a questionnaire survey on HIV KAP. Data was analysed according to their gender, program of study, and academic year. Results. The mean HIV knowledge (HK) and attitude scores were 16.0 and 41.3, respectively. Mean HK score was significantly higher in males compared to females. Significant positive correlations were found between HK and academic year for medical () and nursing () students and between HK and attitude scores (). The majority of students indicated fear in contracting HIV through clinical practice and felt that health care workers have the right to know a patients HIV status for their own safety. The majority would wear gloves to touch a patient if suspected of HIV. Conclusions. The study found a high level of HIV knowledge and positive attitude towards HIV patients. However, respondents also displayed negative attitudes and unacceptable practices probably due to fear. Training institutions need to ensure that students gain accurate knowledge on HIV especially on transmission routes to allay the fear of caring for HIV-infected patients.

Transforming the core business of teaching and learning in classrooms through ICT

Information and Communication Technology (ICT) has become an integral part of societies across the globe. This study demonstrates how successful technology integration by 10 experienced teachers in an Australian high school was dependent on teacher-driven change and innovation that influenced the core business of teaching and learning. The teachers were subject specialists across a range of disciplines, engaging their Year Eight students (aged 12–14 years) in the Technology Rich Classrooms programme. Two classrooms were renovated to accommodate the newly acquired computer hardware. The first classroom adopted a one-to-one desktop model with all the computers with Internet access arranged in a front-facing pattern. The second classroom had computers arranged in small groups. The students also used Blackboard to access learning materials after school hours. Qualitative data were gathered from teachers mainly through structured and unstructured interviews and a range of other approaches to ascertain their perceptions of the new initiative. This investigation showed that ICT was impacting positively on the core business of teaching and learning. Through the support of the school leadership team, the built environment was enabling teachers to use ICT. This influenced their pedagogical approaches and the types of learning activities they designed and implemented. As a consequence, teachers felt that students were motivated and benefited through this experience.

"Nursing is no place for men" ― A thematic analysis of male nursing students experiences of undergraduate nursing education

Background: Surprisingly, opinion about whether men are suitable within the profession continues to be a divided issue. Men enter the profession for a multitude of reasons, yet barriers whether emotional, verbal or sexual are still present. Aim: The aim of this study was to examine the experience of men “training” to be registered nurses within a regional New Zealand context. Design: A Narrative Analysis approach was used. Participants: Five New Zealand men currently undertaking their bachelor of nursing degree at a regional tertiary institute were interviewed as to their experiences of what it meant to be a man in “training”. Method: A thematic analysis was undertaken and guided by an understanding of the way personal narratives informs the human sciences especially within the context of nursing praxis. Four key themes were identified. Results: Four key themes were identified: A career with flexibility and promise; perceived gender inequality in providing care; developing professional boundaries with female colleagues and being unique has its advantages. Conclusion: The men in this study were attracted to the profession by career stability and advancement; the opportunities for travel also figured highly. At times they felt excluded and marginalised because of their minority status within their group and the feminine nature of the curriculum. The men attempted to dispel the myth around male nurse sexual stereotypes. Some of the students behaved in a manner to exert their heterosexualness. The students in this study sensed their vulnerability in choosing nursing as a career. However, all the participants saw nursing as viable and portable career in terms of advancement and travel.

Developments in court to court communications in International insolvency cases

As business increasingly operates on a global basis, courts are called upon more often to adjudicate insolvency cases with international connections. The financial collapse of Lehman Brothers Holding Inc (‘Lehman Holdings’) provides a recent example where courts across many jurisdictions were called upon to determine issues arising from a multistate insolvent enterprise. Lehman Holdings filed for Chapter 11 bankruptcy protection in the United States on 15 September 2008. Lehman Brothers was the fourth largest investment bank in America and the largest company ever to file for bankruptcy in the United States. However the effects of its collapse were felt worldwide, including within Australia.

How can principals enhance teacher job satisfaction and work commitment?

Teachers leave the teaching profession at different stages throughout their careers. When mid-career teachers leave the profession, there is a potential loss of experienced, quality staff. Increasingly principals have the responsibility for recruiting and keeping quality staff, which translates to responsibility for arresting the attrition rate. This paper reports on an ongoing study that investigates how school leadership may affect teacher job satisfaction in order to understand how principals can enhance teacher work commitment. This paper uses the domains of leadership identified in Education Queensland’s Leadership Matters Framework (2008) to compare school leaders’ and teachers’ perceptions about mid-career teachers’ leaving the profession. Five current principals and five ex-teachers participated in semi-structured, qualitative, individual interviews about which leadership practices impact on teacher work commitment. The ideas identified by each cohort were coded through a content analysis. The five domains of leadership (i.e., personal, relational, intellectual, organisational and educational leadership) provided an analytical framework. Both participant groups indicated relational leadership practices as the strongest influence on teacher work commitment. The relational skills, such as valuing staff, being approachable, being consistent with staff interactions, having good interpersonal skills and developing staff strengths, were noted to have specific impacts on teachers’ work commitment. There were significant differences between the groups, with the ex-teachers rating the personal leadership practices as the second most important practice that can influence teacher work commitment. In contrast, the principals felt that the organisational and education leadership practices were of next importance for teacher work commitment. The findings have implications for principal leadership professional learning. Improving relational skills may help school leaders to increase teacher work. Teacher attrition is a serious concern to many education jurisdictions and by understanding reasons for decline in commitment, jurisdictions can redress the negative impact of leadership practices and keep teachers committed and in the profession. However, further research needs to incorporate more participants through a quantitative study to validate connections with the qualitative findings presented in this current study.

Treatment for gender dysphoria in children : the new legal, ethical and clinical landscape

- Gender dysphoria is a condition in which a child's subjectively felt identity and gender are not congruent with her or his biological sex. Because of this, the child suffers clinically significant distress or impairment in social functioning. - The Family Court of Australia has recently received an increasing number of applications seeking authorisation for the provision of hormones to treat gender dysphoria in children. - Some medical procedures and interventions performed on children are of such a grave nature that court authorisation must be obtained to render them lawful. These procedures are referred to as special medical procedures. - Hormonal therapy for the treatment of gender dysphoria in children is provided in two stages occurring years apart. Until recently, both stages of treatment were regarded by courts as special medical treatments, meaning court authorisation had to be provided for both stages. - In a significant recent development, courts have drawn a distinction between the two stages of treatment, permitting parents to consent to the first stage. In addition, it has been held that a child who is determined by a court to be Gillick competent can consent to stage 2 treatment. - The new legal developments concerning treatment for gender dysphoria are of ethical, clinical and practical importance to children and their families, and to medical practitioners treating children with gender dysphoria. Medical practitioners should benefit from an understanding of the recent developments in legal principles. This will ensure that they have up-to-date information about the circumstances under which treatment may be conducted with parental consent, and those in which they must seek court authorisation.

Managing peripheral intravenous devices in the adults' general surgical setting: a best practice implementation report

AIM The aim of this evidence-based practice (EBP) project was to promote adherence to the current best practice in monitoring and optimal replacement of peripheral intravenous device (PIVD). METHODS This EBP project took place in a 30-bed acute general surgical ward. Twenty in-patients with PIVD in situ for 4 days or more were recruited. There were five stages in the project: identification of EBP topic, criteria, sample and setting; baseline; dissemination of baseline audit results and identification of best practice barriers; identification of barriers to EBP and implementation of strategies promoting EBP; and postimplementation audit. RESULTS There were eight criteria in this project. The first audit showed moderate compliance in PIVD monitoring and optimal replacement. The project identified three barriers: lack of awareness of the current evidence-based guidelines, hospital policy not being aligned with current guidelines and no standard form of documentation. In order to overcome these barriers the following strategies were used: audit and feedback, interactive educational meetings, reminders and hospital policy change. The second audit showed minor improvements in each criterion. Compliance with documentation remained a challenge, possibly because of the lack of standardised documentation. DISCUSSION Although the project did not render us the results we aimed for, it was successful because it highlighted the current EBP in PIVD management. The major challenges of the project were time and the lack of opinion leaders in our project team. We felt that more time was needed to adapt to the practice change and standardised documentation could not be developed in such a short time period. Further, the role of the opinion leader proved to be vital in this project. We felt that had we recruited more than one opinion leader, the results would have been different.

Trailing Touch

Trailing Touch (2014) is a twenty minute classically-based dance work set to music by composers Carter Burwell and Hildur Gudnadottir. It is an abstract work that explores images based on imperfect patterns and seeks to transmit the sensations felt when clusters form and disperse through the space or crisscross to create swirling wave-like reactions in the dancers’ tulle skirts. These simple references are inspired by the lyrical use of arms found in ballet, particular to the ballet aesthetic. Trailing Touch was created in collaboration with QUT’s third-year BFA (Dance Performance) students and performed as part of Dance14 at QUT’s Gardens Points Theatre from the 4th to 8th November 2014 and was performed in Singapore as part of Contact Contemporary Dance Festival on 30th November, 2014. Additionally, the creative process of Trailing Touch (2014) forms the initial project of Phase III of my PhD research, Writing the Dance Score in the Twenty-first Century: An approach for the Independent Choreographer. This PhD research will examine the potential of dance scores as a suite of choreographic strategies to map key aspects of the choreographic process. While a certain degree of ambiguity drives the creative process, the suite of choreographic strategies attempt to capture what is transmitted through the lived experience of dance. “[T]hese documents harbor a force of expression, a visual energy related to the body and the movement” (Louppe 1994, 7) that triggers movement responses, unforeseen intensities and enables personal interpretation. Consequently, Phase III will test and evaluate the relevance of Phase II research within the pressures of mainstream dance rehearsal and performance contexts. In Project One Trailing Touch this was demonstrated in the dance scores produced by the choreographer and interpreted by the dancers within the performance. By drawing from both the theoretical and practical, it is anticipated that this research will suggest a form of languaging movement that is not reliant on images or numbers, but generated in response to the intuitive and complex process underpinning choreographic practice. Rather than constructing a codified dance notation system, it will focus on strategies that reveal movement, its spatial patterns, qualities and intensities of expression and the procedures underlying key choreographic concepts. The outcome of this research project aims to support the independent choreographer in two major areas, by facilitating and enriching the choreographic process for both the performers and choreographer, and by strengthening artistic development and performance outcomes.

Growing demand for emergency department services : associated factors and perspective of patients

This thesis demonstrates how patients' perceived urgency affects their decision to use public hospital emergency departments. The findings inform public health policy solutions aimed at reducing rapid growth in emergency department utilisation which results in congestion and affects the safety, satisfaction, and the quality of care. This research identified that patients attending emergency departments did so based on the perception of their own health status and beliefs that emergency departments were the most suitable location for their care. Blaming patients as "frequent flyers" or "inappropriate users" ignores the complex and multi-factorial nature of the genuine need for urgent medical care felt by patients.

Balancing the books : an assessment of financial stress associated with social work and human service student placements

This report presents the findings from a study of the financial impact of work-integrated learning commonly referred to as 'placement' among social work and human services students. Based on a survey of 214 respondants, 14 in-depth interviews and two focus groups, the findings indicate that two thirds of the surveyed group felt tired and anxious about their experience of balancing paid work and placement, with 2 in 5 reporting their learning experience was compromised as a result. The significant implications and potential solutions are also discussed.

The history, content and evolution of The International Journal of the First Year in Higher Education

The International Journal of the First Year in Higher Education (Int J FYHE) began in 2010 with a specific FYHE focus and has published two issues per year with one issue linked to The International First Year in Higher Education Conference (FYHE Conference). This issue—Volume 6, Issue 1—is the last under this title. In 2015 the Journal will align to a new conference that has a broader focus on Students, Transitions, Achievement, Retention and Success (STARS). At this significant point and before we move on to the new journal, the journal team felt it was appropriate that the Feature in this final issue of the Int J FYHE should summarise the Journal’s activity over the years from 2010 to 2014.