Implementing an emergency department patient admission predictive tool : insights from practice

Purpose: This paper aims to show that identification of expectations and software functional requirements via consultation with potential users is an integral component of the development of an emergency department patient admissions prediction tool. ---------- Design/methodology/approach: Thematic analysis of semi-structured interviews with 14 key health staff delivered rich data regarding existing practice and future needs. Participants included emergency department staff, bed managers, nurse unit managers, directors of nursing, and personnel from health administration. ---------- Findings: Participants contributed contextual insights on the current system of admissions, revealing a culture of crisis, imbued with misplayed communication. Their expectations and requirements of a potential predictive tool provided strategic data that moderated the development of the Emergency Department Patient Admissions Prediction Tool, based on their insistence that it feature availability, reliability and relevance. In order to deliver these stipulations, participants stressed that it should be incorporated, validated, defined and timely. ---------- Research limitations/implications: Participants were envisaging a concept and use of a tool that was somewhat hypothetical. However, further research will evaluate the tool in practice. ---------- Practical implications: Participants' unsolicited recommendations regarding implementation will not only inform a subsequent phase of the tool evaluation, but are eminently applicable to any process of implementation in a healthcare setting. ---------- Originality/value: The consultative process engaged clinicians and the paper delivers an insider view of an overburdened system, rather than an outsider's observations.

Improving reflective writing in higher education : A social semiotic perspective

Reflective skills are widely regarded as a means of improving students’ lifelong learning and professional practice in higher education (Rogers 2001). While the value of reflective practice is widely accepted in educational circles, a critical issue is that reflective writing is complex, and has high rhetorical demands, making it difficult to master unless it is taught in an explicit and systematic way. This paper argues that a functional-semantic approach to language (Eggins 2004), based on Halliday’s (1978) systemic functional linguistics can be used to develop a shared language to explicitly teach and assess reflective writing in higher education courses. The paper outlines key theories and scales of reflection, and then uses systemic functional linguistics to develop a social semiotic model for reflective writing. Examples of reflective writing are analysed to show how such a model can be used explicitly to improve the reflective writing skills of higher education students.

Contact Lens Practice, 2nd Edition

Thoroughly revised and updated, this popular book provides a comprehensive yet easy to read guide to modern contact lens practice. Beautifully re-designed in a clean, contemporary layout, this second edition presents relevant and up-to-date information in a systematic manner, with a logical flow of subject matter from front to back. This book wonderfully captures the ‘middle ground’ in the contact lens field … somewhere between a dense research-based tome and a basic fitting guide. As such, it is ideally suited for both students and general eye care practitioners who require a practical, accessible and uncluttered account of the contact lens field. Contents Part 1 Introduction Historical perspective. The anterior eye Visual optics Clinical instruments Part 2 Soft contact lenses Soft lens materials Soft lens manufacture Soft lens optics Soft lens measurement Soft lens design and fitting Soft toric lens design and fitting Soft lens care systems Part 3 Rigid contact lenses Rigid lens materials Rigid lens manufacture Rigid lens optics Rigid lens measurement Rigid lens design and fitting Rigid toric lens design and fitting Rigid lens care systems Part 4 Lens replacement modalities Unplanned lens replacement Daily soft lens replacement Planned soft lens replacement Planned rigid lens replacement Part 5 Special lenses and fitting considerations Scleral lenses Tinted lenses Presbyopia Continuous wear Sport Keratoconus High ametropia Paediatric fitting Therapeutic applications Post-refractive Surgery Post-keratoplasty Orthokeratology Diabetes Part 6 Patient examination and management History taking Preliminary examination Patient education Aftercare Complications Digital imaging Compliance Practice management Appendices Index

The digital economy bill and the UK’s creative industries : a perspective from China

The Digital Economy Bill has been heavily criticized by consumer organizations, internet service providers and technology experts on the grounds that it will reduce the public’s ability to access politically sensitive information, impinge on citizens’ rights to privacy, threaten freedom of expression and have a chilling effect on digital innovation. Its passage in spite of these criticisms reflects, among other things, the power of the rhetoric that has been employed by its proponents. This paper examines economic arguments surrounding the digital economy debate in light of lessons from one of the world's fastest growing economies: China.

Potential of St John's Wort for the treatment of depression : the economic perspective

The burden of rising health care expenditures has created a demand for information regarding the clinical and economic outcomes associated with complementary and alternative medicines. Meta-analyses of randomized controlled trials have found Hypericum perforatum preparations to be superior to placebo and similarly effective as standard antidepressants in the acute treatment of mild to moderate depression. A clear advantage over antidepressants has been demonstrated in terms of the reduced frequency of adverse effects and lower treatment withdrawal rates, low rates of side effects and good compliance, key variables affecting the cost-effectiveness of a given form of therapy. The most important risk associated with use is potential interactions with other drugs, but this may be mitigated by using extracts with low hyperforin content. As the indirect costs of depression are greater than five times direct treatment costs, given the rising cost of pharmaceutical antidepressants, the comparatively low cost of Hypericum perforatum extract makes it worthy of consideration in the economic evaluation of mild to moderate depression treatments.

The provision of patient personal hygiene in the intensive care unit : a descriptive exploratory study of bed-bathing practice

Background/objectives The provision of the patient bed-bath is a fundamental nursing care activity yet few quantitative data and no qualitative data are available on registered nurses’ (RNs) clinical practice in this domain in the intensive care unit (ICU). The aim of this study was to describe ICU RNs current practice with respect to the timing, frequency and duration of the patient bed-bath and the cleansing and emollient agents used. Methods The study utilised a two-phase sequential explanatory mixed method design. Phase one used a questionnaire to survey RNs and phase two employed semi-structured focus group (FG) interviews with RNs. Data was collected over 28 days across four Australian metropolitan ICUs. Ethical approval was granted from the relevant hospital and university human research ethics committees. RNs were asked to complete a questionnaire following each episode of care (i.e. bed-bath) and then to attend one of three FG interviews: RNs with less than 2 years ICU experience; RNs with 2–5 years ICU experience; and RNs with greater than 5 years ICU experience. Results During the 28-day study period the four ICUs had 77.25 beds open. In phase one a total of 539 questionnaires were returned, representing 30.5% of episodes of patient bed-baths (based on 1767 bed occupancy and one bed-bath per patient per day). In 349 bed-bath episodes 54.7% patients were mechanically ventilated. The bed-bath was given between 02.00 and 06.00 h in 161 episodes (30%), took 15–30 min to complete (n = 195, 36.2%) and was completed within the last 8 h in 304 episodes (56.8%). Cleansing agents used were predominantly pH balanced soap or liquid soap and water (n = 379, 71%) in comparison to chlorhexidine impregnated sponges/cloths (n = 86, 16.1%) or other agents such as pre-packaged washcloths (n = 65, 12.2%). In 347 episodes (64.4%) emollients were not applied after the bed-bath. In phase two 12 FGs were conducted (three FGs at each ICU) with a total of 42 RN participants. Thematic analysis of FG transcripts across the three levels of RN ICU experience highlighted a transition of patient hygiene practice philosophy from shades of grey – falling in line for inexperienced clinicians to experienced clinicians concrete beliefs about patient bed-bath needs. Conclusions This study identified variation in process and products used in patient hygiene practices in four ICUs. Further study to improve patient outcomes is required to determine the appropriate timing of patient hygiene activities and cleansing agents used to improve skin integrity.

Kidlit from a graduate student's perspective : a problem in theory?

Plenary Session: "New Voices in Children's Literature"

The Early Prevention of Obesity in CHildren (EPOCH) collaboration : an individual patient data prospective meta-analysis

Background: Efforts to prevent the development of overweight and obesity have increasingly focused early in the life course as we recognise that both metabolic and behavioural patterns are often established within the first few years of life. Randomised controlled trials (RCTs) of interventions are even more powerful when, with forethought, they are synthesised into an individual patient data (IPD) prospective meta-analysis (PMA). An IPD PMA is a unique research design where several trials are identified for inclusion in an analysis before any of the individual trial results become known and the data are provided for each randomised patient. This methodology minimises the publication and selection bias often associated with a retrospective meta-analysis by allowing hypotheses, analysis methods and selection criteria to be specified a priori. Methods/Design: The Early Prevention of Obesity in CHildren (EPOCH) Collaboration was formed in 2009. The main objective of the EPOCH Collaboration is to determine if early intervention for childhood obesity impacts on body mass index (BMI) z scores at age 18-24 months. Additional research questions will focus on whether early intervention has an impact on children’s dietary quality, TV viewing time, duration of breastfeeding and parenting styles. This protocol includes the hypotheses, inclusion criteria and outcome measures to be used in the IPD PMA. The sample size of the combined dataset at final outcome assessment (approximately 1800 infants) will allow greater precision when exploring differences in the effect of early intervention with respect to pre-specified participant- and intervention-level characteristics. Discussion: Finalisation of the data collection procedures and analysis plans will be complete by the end of 2010. Data collection and analysis will occur during 2011-2012 and results should be available by 2013. Trial registration number: ACTRN12610000789066

Avoidance of advertising on social networking sites : the teenage perspective

Technology has provided consumers with the means to control and edit the information that they receive and share effectively, especially in the online environment. Although previous studies have investigated advertising avoidance in traditional media and on the Internet, there has been little investigation of advertising on social networking sites. This exploratory study examines the antecedents of advertising avoidance on online social networking sites, leading to the development of a model. The model suggests that advertising in the online social networking environment is more likely to be avoided if the user has expectations of a negative experience, the advertising is not relevant to the user, the user is skeptical toward the advertising message, or the consumer is skeptical toward the advertising medium.

Sports sponsorship as an integrated marketing communications tool : an Australian sponsor's perspective

Sports sponsorship increasingly provides organisations with the opportunity to reach their target audiences in a manner that facilitates engagement and encourages relationship development. This paper provides an Australian perspective of the value of sports sponsorship using a case study of WOW Sight and Sound’s long-term sponsorship of the Brisbane Broncos rugby league team. The case study investigates WOW’s marketing objectives which centre generating brand awareness using sponsorship with the Brisbane Broncos as an integrated marketing communications tool. WOW believes that the integration of its sponsorship of the Broncos with the team’s total marketing plan is integral to its success. This integration requires the facilitation of two-way communications between WOW, its advertising agency, the Brisbane Broncos and customers to ensure that all parties’ needs are met.

Dealing with unique interests in Crown Land : a Queensland perspective

Security of tenure is the cornerstone of the land management system in Australia. Freehold title is protected throug indefeasibility of title entrenched in legislation and protection of registrable interests in land is offered through the Statutory Assurance Fund. For those with interests pertaining to Crown Land no such protection is offered, although this position is not uniform across Australia. Notably those with Crown leasehold interests or a profit a prendre on Crown Land in Queensland are not protected through registration on the freehold land register and do not have the benefit of indefeasibility of title. The issue of management of interests pertaining to Crown Land has become increasingly relevant due to the complexities associated with balancing public interests including native title with more commercial interests in land generated through carbon sequestration, forestry and mining. This paper considers the framework for the management of Crown Land in Queensland and the adequacy of this framework for commercial interests that pertain to Crown Land.

Citizen consultation from above and below : the Australian perspective

Citizen engagement and e‐government initiatives in Australia remain somewhat underdeveloped, not least for a number of fundamental structural reasons. Fledgling initiatives can be divided into a number of broad categories, including top‐down government consultation through blogs and similar experimental online sites operated by government departments; bottom‐up NGO‐driven watchdog initiatives such as GetUp!’s Project Democracy site, modelled on projects established in the UK; and a variety of more or less successful attempts by politicians (and their media handlers) to utilise social networking tools to connect with constituents while bypassing the mainstream media. This chapter explores these initiatives, and discusses the varying levels of success which they have found to date.

Modelling web search behaviour : a user’s cognitive style perspective [Unpublished]

Many researchers have investigated and modelled aspects of Web searching. A number of studies have explored the relationships between individual differences and Web searching. However, limited studies have explored the role of users’ cognitive styles in determining Web searching behaviour. Current models of Web searching have limited consideration of users’ cognitive styles. The impact of users’ cognitive style on Web searching and their relationships are little understood or represented. Individuals differ in their information processing approaches and the way they represent information, thus affecting their performance. To create better models of Web searching we need to understand more about user’s cognitive style and their Web search behaviour, and the relationship between them. More rigorous research is needed in using more complex and meaningful measures of relevance; across a range of different types of search tasks and different populations of Internet users. The project further explores the relationships between the users’ cognitive style and their Web searching. The project will develop a model depicting the relationships between a user’s cognitive style and their Web searching. The related literature, aims and objectives and research design are discussed.

Affordable housing solutions : affordable housing providers’ perspective

Accessibility to housing for low to moderate income groups in Australia has experienced a severe decline since 2002. On the supply side, the public sector has been reducing its commitment to the direct provision of public housing. Despite strong demand for affordable housing, limited supply has been generated by non-government housing providers. This paper identifies and discusses some current affordable housing solutions which have been developed by non-government housing providers to ameliorate the problem. This study utilises case studies generated from nineteen housing providers during in-depth interviews in South East Queensland in 2007-2008. The case studies are classified into four categories which relate to the nature of their product: affordable rental housing, mixed housing, affordable housing for people with special needs and low cost home ownership. Each category is discussed on the basis of the characteristics typical of that organisation of housing provider, their partnership arrangements and main target market. In addition, the special design and facilities required for people with special needs which include high care accommodation and aged care are highlighted. Finally, this study recommends offering a continuum of solutions to affordable housing for low income people by means of a rent-to-buy scheme.

Affordable housing solutions : affordable housing providers’ perspective

Accessibility to housing for low to moderate income groups in Australia has been experiencing a severe decline since 2002. On the supply side, the public sector has been reducing its commitment to the direct provision of public housing. Despite strong demand for affordable housing, limited supply has been generated by nongovernment housing providers. This paper identifies and discusses some current affordable housing solutions to ameliorate the problem which have been developed by non-government housing providers. This study utilises case studies generated from nineteen housing providers during indepth interviews in South East Queensland in 2007-2008. The case studies are classified into four categories which relate to the nature of their product: affordable rental housing, mixed housing, affordable housing for people with special needs and low cost home ownership. Each category is discussed on the basis of the characteristics typical of that organisation of housing provider, their partnership arrangements and main target market. In addition, the special design and facilities required for people with special needs which include high care accommodation and aged care are highlighted. Finally, this study recommends offering a continuum of solutions to affordable housing for low income people by means of a rent-to-buy scheme.