Access to Cardiac Rehabilitation does not Equate to Attendance. (On Behalf of the Cardiac ARIA Project. Winner Nursing/Allied Health Professional Investigator Award)

Background/Aims Timely access to appropriate cardiac care is critical for optimizing positive outcomes after a cardiac event. Attendance at cardiac rehabilitation (CR) remains less than optimal (10%–30%). Our aim was to derive an objective, comparable, geographic measure reflecting access to cardiac services after a cardiac event in Australia. Methods An expert panel defined a single patient care pathway and a hierarchy of the minimum health services for CR and secondary prevention. Using geographic information systems a numeric/alpha index was modelled to describe access before and after a cardiac event. The aftercare phase was modelled into five alphabetical categories: from category A (access to medical service, pharmacy, CR, pathology within 1 h) to category E (no services available within 1 h). Results Approximately 96% or 19 million people lived within 1 h of the four basic services to support CR and secondary prevention, including 96% of older Australians and 75% of the indigenous population. Conversely, 14% (64,000) indigenous people resided in population locations that had poor access to health services that support CR after a cardiac event. Conclusion Results demonstrated that the majority of Australians had excellent ‘geographic’ access to services to support CR and secondary prevention. Therefore, it appears that it is not the distance to services that affects attendance. Our ‘geographic’ lens has identified that more research on socioeconomic, sociological or psychological aspects to attendance is needed.

The Development of Competency Standards for Specialist Critical Care Nurses

In defining the contemporary role of the specialist nurse it is necessary to challenge the concept of nursing as merely a combination of skills and knowledge. Nursing must be demonstrated and defined in the context of client care and include the broader notions of professional development and competence. This qualitative study sought to identify the competency standards for nurse specialists in critical care and to articulate the differences between entry-to-practice standards and the advanced practice of specialist nurses. Over 800 hours of specialist critical care nursing practice were observed and grouped into 'domains' or major themes of specialist practice using a constant comparison qualitative technique. These domains were further refined to describe attributes of the registered nurses which resulted in effective and/or superior performance (competency standards) and to provide examples of performance (performance criteria) which met the defined standard. Constant comparison of the emerging domains, competency standards and performance criteria to observations of specialist critical care practice, ensured the results provided a true reflection of the specialist nursing role. Data analysis resulted in 20 competency standards grouped into six domains: professional practice, reflective practice, enabling, clinical problem solving, teamwork, and leadership. Each of these domains is comprised of between two and seven competency standards. Each standard is further divided into component parts or 'elements' and the elements are illustrated with performance criteria. The competency standards are currently being used in several Australian critical care educational programmes and are the foundation for an emerging critical care credentialling process. They have been viewed with interest by a variety of non-critical care specialty groups and may form a common precursor from which further specialist nursing practice assessment will evolve.

Developing authentic professional knowledge through transformative community engagement in an interdisciplinary service learning project

This showcase presents a preliminary analysis of a community service learning project designed to align more authentically with contemporary society and emerging constructs of professional knowledge. As described in the paper, the project involves a multidisciplinary group of students working collaboratively with a community organisation to find creative presponses to challenging issues concerning the organisation's identity, how it interfaces with stakeholders, and how it evidences its inclusive practice. Of particular interest is how the interdisciplinary practice of the students within a service learning context encouraged reconsideration of their world0view and their rols as future professionals. Also highlighted is the need for greater congruence between the goals of the project and the structural elements of the curriculum.

Does the addition of integrated cognitive behaviour therapy and motivational interviewing improve the outcomes of standard care for young people with comorbid depression and substance misuse?

Background: The high rates of comorbid depression and substance use in young people have been associated with a range of adverse outcomes. Yet, few treatment studies have been conducted with this population. Objective: To determine if the addition of Motivational Interviewing and Cognitive Behaviour Therapy (MI/CBT) to standard alcohol and other drug (AOD) care improves the outcomes of young people with comorbid depression and substance use. Participants and Setting: Participants comprised 88 young people with comorbid depression (Kessler 10 score of > 17) and substance use (mainly alcohol/cannabis) seeking treatment at two youth AOD services in Melbourne, Australia. Sixty young people received MI/CBT in addition to standard care (SC) and 28 received SC alone. Outcomes Measures: Primary outcome measures were depressive symptoms and drug and alcohol use in the past month. Assessments were conducted at baseline, 3 and 6 months follow up. Results and Conclusions: The addition of MI/CBT to SC was associated with a significantly greater rate of change in depression, cannabis use, motivation to change substance use and social contact in the first 3 months. However, those who received SC had achieved similar improvements on these variables by 6 months follow up. All young people achieved significant improvements in functioning and quality of life variables over time, regardless of the treatment group. No changes in alcohol or other drug use were found in either group. The delivery of MI/CBT in addition to standard AOD care may offer accelerated treatment gains in the short-term.

Learning about being effective mentors : professional learning communities and mentoring

This study aimed to explore experienced mentors’ understandings about professional learning communities (PLCs), mentoring and leadership. This research analyses audio-taped transcripts and written responses from 27 experienced mentors who operate in varied roles (e.g., university academics, school executives, teachers, learning support personnel). Findings indicated that PLCs can provide professional renewal for existing teachers and that mentoring within PLCs can further advance knowledge about effective practices. PLCs can include other staff members and key stakeholders (e.g., preservice teachers, teacher aides) who can contribute to the learning within the group. Mentoring and PLCs can be cost-effective strategic levers for advancing professional knowledge.

Accelerated professional development and peer consultation : two strategies for continuing professional education for nurses

A comparison was made of accelerated professional development (APD) for nurses (n=64), involving peer consultation and reflective practice, and peer consultation alone (n=30). Although APD participants had a higher completion rate, improvements in caregiver behaviors and work environment were not significantly different.

Embedding information and communication technologies in the early childhood classroom

New technologies and the pace of change in modern society mean changes for classroom teaching and learning. Information and communication technologies (ICTs) feature in everyday life and provide ample opportunities for enhancing classroom programs. This article outlines how ICTs complement curriculum implementation in one year two classroom. It suggests practical strategies demonstrating how teachers can make ICTs work for them and progressively teach children how to make ICTs work for them.

'Going live' : establishing the creative attributes of the live multi-camera television professional

In my capacity as a television professional and teacher specialising in multi-camera live television production for over 40 years, I was drawn to the conclusion that opaque or inadequately formed understandings of how creativity applies to the field of live television, have impeded the development of pedagogies suitable to the teaching of live television in universities. In the pursuit of this hypothesis, the thesis shows that television degrees were born out of film studies degrees, where intellectual creativity was aligned to single camera production, and the 'creative roles' of producers, directors and scriptwriters. At the same time, multi-camera live television production was subsumed under the 'mass communication' banner, leading to an understanding that roles other than producer and director are simply technical, and bereft of creative intent or acumen. The thesis goes on to show that this attitude to other television production personnel, for example, the vision mixer, videotape operator and camera operator, relegates their roles to that of 'button pusher'. This has resulted in university teaching models with inappropriate resources and unsuitable teaching practices. As a result, the industry is struggling to find people with the skills to fill the demands of the multi-camera live television sector. In specific terms the central hypothesis is pursued through the following sequenced approach. Firstly, the thesis sets out to outline the problems, and traces the origins of the misconceptions that hold with the notion that intellectual creativity does not exist in live multi-camera television. Secondly, this more adequately conceptualised rendition, of the origins particular to the misconceptions of live television and creativity, is then anchored to the field of examination by presentation of the foundations of the roles involved in making live television programs, using multicamera production techniques. Thirdly, this more nuanced rendition of the field sets the stage for a thorough analysis of education and training in the industry, and teaching models at Australian universities. The findings clearly establish that the pedagogical models are aimed at single camera production, a position that deemphasises the creative aspects of multi-camera live television production. Informed by an examination of theories of learning, qualitative interviews, professional reflective practice and observations, the roles of four multi-camera live production crewmembers (camera operator, vision mixer, EVS/videotape operator and director's assistant), demonstrate the existence of intellectual creativity during live production. Finally, supported by the theories of learning, and the development and explication of a successful teaching model, a new approach to teaching students how to work in live television is proposed and substantiated.

Symposium - How effective are brief motivational interviewing interventions : Are they necessary? Do they require enhancement? Can they be translated into routine clinical practice?

Brief interventions are effective for problem drinking and reductions are known to occur in association with screening and assessment. Design and methods: This study aimed to determine how much change occurred between baseline assessment and a one-session brief intervention (S1), and the predictors of early change among adults with comorbid depression and alcohol misuse (n=202) participating in a clinical trial. The primary focus was on changes in Beck Depression Inventory fastscreen scores and alcohol consumption (standard drinks per week) prior to random allocation to nine further sessions addressing either depression, alcohol, or both problems. Results: There were large and clinically significant reductions between baseline and S1, with the strongest predictors being baseline scores in the relevant domain and change in the other domain. Client engagement was also predictive of early depression changes. Discussion and Conclusion: Monitoring progress in both domains from first contact, and provision of empathic care, followed by brief intervention appear to be useful for this high prevalence comorbidity...

Thai family support (TFS) : working with families of young substance users in primary health care

Living with substance users negatively impacts upon family members in many ways, and distress is common. Despite these deep and wide-ranging impacts, supportive interventions for family members in their own right are rarely available. Thailand has substantial and growing problems with substance use, and there is very little support or family members of drug users, especially in community setting. The Thai Family Support (TFS) program was designed for implementation in primary health care units (PCUs) in Thailand. TFS was based on two approaches with existing empirical support in Western contexts—the 5-step method and CRAFT—with adaptations to a Thai setting that included integration with Buddhist practices. Its aims were to increase well-being of family members, reduce mental distress, improve family relationships between family members, and engage substance users in behaviour change. A small-scale randomised controlled trial on TFS with a Delayed Treatment control was conducted, with assessments at 8 weeks (Post 1) and 20-24 weeks (Post 2). Structured interviews with participants and PCU staff and an examination of five case studies augmented the quantitative results. Mixed Model Analyses were applied to quantitative outcomes, and thematic analysis was used for qualitative data. Thirty-six participants (18 in each of Immediate and Delayed Conditions) were recruited. A significant difference at Baseline between the two conditions was observed on the Thai GHQ-28 and Gender, but it was not possible to statistically control for these effects. There was a significant Time by Condition interaction on the Thai GHQ-28, WHOQOL-BREF-THAI and FAS, reflecting greater improvements in the Immediate condition by Post 1, but with the Delayed condition meeting or exceeding that effect by Post 2. On FES Cohesion and Conflict, there were falls across conditions at Post 2, but only Cohesion also showed a Time by Condition interaction, and that effect was consistent with a delayed impact of treatment. Overall, TFS by PCU staff in the Delayed Condition gave similar results to TFS conducted by the researcher, supporting the viability of its dissemination to standard health services. Qualitative data also confirmed the quantitative results. Most participants reported physiological and psychological improvements even though their substance-using relative did not change their drug use behaviour. After completing TFS, participants reported increased knowledge, group support and sharing feeling, having positive patient-professional relationship, having greater knowledge of substance abuse and social support. In particular, they changed their behaviour towards the substance user, resulting in improvements to family relationships. PCU staff gave similar responses on the efficacy of TFS, and saw it as feasible for routine use, although some implementation challenges were identified. The cultural adaptation and in particular the religious activities, were recognised by participants and PCU staff as an important component of TFS to support psychological health and well-being. Findings from this study showed the impact of substance use on family members and difficulties that they experienced when living with the substance users, resulting distresses and burden that may develop severe mental health disease. Drug use policies should be modified to support family members and response to their needs effectively for early prevention. This study also gave preliminary support for application of the TFS program in rural primary care settings and identified some policies that will be required for it to be disseminated more broadly.

Fundamentals of business process management

Encompasses the whole BPM lifecycle, including process identification, modelling, analysis, redesign, automation and monitoring Class-tested textbook complemented with additional teaching material on the accompanying website Covers both relevant conceptual background, industrial standards and actionable skills Business Process Management (BPM) is the art and science of how work should be performed in an organization in order to ensure consistent outputs and to take advantage of improvement opportunities, e.g. reducing costs, execution times or error rates. Importantly, BPM is not about improving the way individual activities are performed, but rather about managing entire chains of events, activities and decisions that ultimately produce added value for an organization and its customers. This textbook encompasses the entire BPM lifecycle, from process identification to process monitoring, covering along the way process modelling, analysis, redesign and automation. Concepts, methods and tools from business management, computer science and industrial engineering are blended into one comprehensive and inter-disciplinary approach. The presentation is illustrated using the BPMN industry standard defined by the Object Management Group and widely endorsed by practitioners and vendors worldwide. In addition to explaining the relevant conceptual background, the book provides dozens of examples, more than 100 hands-on exercises – many with solutions – as well as numerous suggestions for further reading. The textbook is the result of many years of combined teaching experience of the authors, both at the undergraduate and graduate levels as well as in the context of professional training. Students and professionals from both business management and computer science will benefit from the step-by-step style of the textbook and its focus on fundamental concepts and proven methods. Lecturers will appreciate the class-tested format and the additional teaching material available on the accompanying website fundamentals-of-bpm.org.

Mentoring as professional development: ‘growth for both’ mentor and mentee

Teachers need professional development to keep current with teaching practices, although costs for extensive professional development can be prohibitive across an education system. Mentoring provides one way for embedding cost-effective professional development. This mixed-method study includes surveying mentor teachers (n = 101) on a five-part Likert scale and interviews with experienced mentors (n = 10) to investigate professional development for mentors as a result of the mentoring process. Quantitative data were analysed through a pedagogical knowledge framework and qualitative data were collated into themes. Survey data showed that although mentoring of pedagogical knowledge was variable, mentoring pedagogical knowledge practices occurs with the majority of mentors, which requires mentors to evaluate and articulate teaching practices. Qualitative data showed that mentoring acted as professional development and led towards enhancing communication skills, developing leadership roles (problem-solving and building capacity) and advancing pedagogical knowledge. Providing professional development to teachers on mentoring can help to build capacity in two ways: quality mentoring of preservice teachers through explicit mentoring practices, and reflecting and deconstructing teaching practices for mentors’ own pedagogical advancements.

User facilitated congestion and attack mitigation

The IEEE Wireless LAN standard has been a true success story by enabling convenient, efficient and low-cost access to broadband networks for both private and professional use. However, the increasing density and uncoordinated operation of wireless access points, combined with constantly growing traffic demands have started hurting the users' quality of experience. On the other hand, the emerging ubiquity of wireless access has placed it at the center of attention for network attacks, which not only raises users' concerns on security but also indirectly affects connection quality due to proactive measures against security attacks. In this work, we introduce an integrated solution to congestion avoidance and attack mitigation problems through cooperation among wireless access points. The proposed solution implements a Partially Observable Markov Decision Process (POMDP) as an intelligent distributed control system. By successfully differentiating resource hampering attacks from overload cases, the control system takes an appropriate action in each detected anomaly case without disturbing the quality of service for end users. The proposed solution is fully implemented on a small-scale testbed, on which we present our observations and demonstrate the effectiveness of the system to detect and alleviate both attack and congestion situations.

Visualization of thermal characteristics around the absorber tube of a standard parabolic trough thermal collector by 3D simulation

Three dimensional conjugate heat transfer simulation of a standard parabolic trough thermal collector receiver is performed numerically in order to visualize and analyze the surface thermal characteristics. The computational model is developed in Ansys Fluent environment based on some simplified assumptions. Three test conditions are selected from the existing literature to verify the numerical model directly, and reasonably good agreement between the model and the test results confirms the reliability of the simulation. Solar radiation flux profile around the tube is also approximated from the literature. An in house macro is written to read the input solar flux as a heat flux wall boundary condition for the tube wall. The numerical results show that there is an abrupt variation in the resultant heat flux along the circumference of the receiver. Consequently, the temperature varies throughout the tube surface. The lower half of the horizontal receiver enjoys the maximum solar flux, and therefore, experiences the maximum temperature rise compared to the upper part with almost leveled temperature. Reasonable attributions and suggestions are made on this particular type of conjugate thermal system. The knowledge that gained so far from this study will be used to further the analysis and to design an efficient concentrator photovoltaic collector in near future.