Can the Cardiac ARIA Index Improve Cardiac Care for Australia's Indigenous Population?

Background: Timely access to appropriate cardiac care is critical for optimising outcomes. Our aim was to derive an objective, comparable, geographic measure reflecting access to cardiac services for Australia's 20,387 population locations. Methods: An expert panel defined a single patient care pathway. Using geographic information systems (GIS) the numeric/alpha index was modelled in two phases. The acute phase index (numeric) ranged from 1 (access to tertiary centre with PCI ≤1 h) to 8 (no ambulance service, >3 h to medical facility, air transport required). The aftercare index was modelled into 5 alphabetic categories; A (Access to general practitioner, pharmacy, cardiac rehabilitation, pathology ≤1 h) to E (no services available within 1 h). Results: Approximately 70% or 13.9 million people lived within a CardiacARIAindex category 1A location. Disparity continues in access to category 1A cardiac services for 5.8 million (30%) of all Australians, 60% of Aboriginal and Torres Strait Islander people and 32% of people over 65 years of age. In a cardiac emergency only 40% of the Indigenous population reside within one hour of category 1 hospital. Approximately 30% (81,491 Indigenous persons) are more than one to three hours from basic cardiac services. Conclusion: Geographically, the majority of Australian's have timely access for survival of a cardiac event. The CardiacARIAindex objectively demonstrates that the healthcare system may not be providing for the needs of 60% of Indigenous people residing outside the 1A geographic radius. Innovative clinical practice maybe required to address these disparities.

Mothers of young children with special health care needs : maternal well-being and engagement in work

This thesis reports research focused on the well-being and employment experiences of mothers who have a child with special health care needs. Data are drawn from Growing Up in Australia: The Longitudinal Study of Australian Children (LSAC). This is a public access database. The thesis uses the social ecological theory of Bronfenbrenner (1984) and the work of Zubrick et al. (2000) on human and social capital to inform the conceptual framework developed for the research. Four studies are reported. LSAC has a nationally representative sample of Australian children and their families. The study is tracking the development of 10,000 children, with data collected every two years, from 2004 to 2018. This thesis uses data from the Kindergarten Cohort of LSAC. The 4,983 children in the Kindergarten Cohort were aged 4 years at recruitment into the study in 2004. The analyses in this thesis use child and family data from Wave 1 (2004) and Wave 2 (2006) for a subsample of the children who are identified as having special health needs. This identification is based on a short screening questionnaire included in the Parent 1 Interview at each wave of the data collection. It is the children who are identified as having special health care needs which can be broadly defined as chronic health conditions or developmental difficulties. However, it is the well-being and employment experiences of the mothers of these children that are the primary focus in three of the four studies reported in this thesis.

Australian children with special health care needs: Social-emotional and learning competencies in the early years

This study examined the relationship between special health care needs and social-emotional and learning competence in the early years, reporting on two waves of data from the Kindergarten Cohort of Growing up in Australia: The Longitudinal Study of Australian Children (LSAC). Six hundred and fifty children were identified through the 2-question Special Health Care Needs Screener as having special health care needs. Children with special health care needs were more likely to be male, to have been of low birth weight, to be taking prescription medications, to be diagnosed with a specific health condition and to be from families where the mother was less well educated. These children scored significantly lower on teacher-rated social-emotional and learning competencies prior to school compared to a control group of children without special health care needs. Multiple regression analyses indicated that being identified with a special health care need prior to school predicted lower social-emotional and learning competencies in the early years of school. Results are discussed in terms of the implications for policy and practice.

Industry needs and course content in project management

The new competitive international business environment is characterised by constant change and uncertainty. This is particularly true in project-oriented industries such as construction where subcontracting and competitive tendering add new dimensions to an already uncertain working environment. Many management writers and practitioners argue that the changing business environment and the speed required to design, develop and market products and services will lead to increasing use of project management in the future. This means that project management skills will become a competitive weapon for those individuals and firms that properly develop them.

Jury option needs early verdict

The decision in Rubin v Buchanan [2011] QSC 275 confirms that a trial by jury should be considered at the outset of a proceeding.

Leadership practices of Kuwaiti Secondary School Principals for embedding ICT

Globalisation and the emergence of knowledge-based economies have forced many countries to reform their education system. The enhancement of human capital to meet modern day demands of a knowledge economy, and equip the new generation with the capacity to meet the challenges of the 21st Century has become a priority. This change is particularly necessary in economies typical of countries, such as Kuwait, which have been dependent on the exploitation of non-renewable natural resources. Transiting from a resource-based economy to an economy based on knowledge and intellectual skills poses a key challenge for an education system. Significant in the development of this new economy has been the expansion of Information Communication Technology (ICT). In education, in particular, ICT is a tool for transforming the education setting. However, transformation is only successful where there are effective change management strategies and appropriate leadership. At the school level, rapid changes have affected the role that principals take particularly in relation to leading the change process. Therefore, this study investigated the leadership practices of school principals for embedding ICT into schools. The case study assessed two Kuwaiti secondary schools; both schools had well established ICT programs. The mode of data collection used a mixed-methods design, to address the purpose of the study, namely, to examine the leadership practices of school principals when managing the change processes associated with embedding ICT in the context of Kuwait. A theoretical model of principal leadership, developed, from the literature, documented and analysed the practices of the respective school principals. The study used the following five data sources: (a) face to face interviews (with each school principal), and two focus group interviews (with five teachers and five students, from each school); (b) school documents (related to the implementation and embedding of ICT); (c) one survey (of all teachers in each school); (d) an open-ended questionnaire (of participating principals and teachers); and (e) the observation of ICT activities (PD ICT activities and instruction meetings). The study revealed a range of strategies used by the principals and aligned with the theoretical perspective. However, these strategies needed to be refined and selectively used to fit the Kuwait context, both culturally and organisationally. The principals of Schools A and B employed three key strategies to maximise the impact on the teaching staff incorporating ICT into their teaching and learning practices. These strategies were: (a) encouragement for teaching staff to implement ICT in their teaching; (b) support to meet the material and human needs of teaching staff using ICT; and (c) provision of instructions and guidance for teaching staff in how and why such behaviours and practices should be performed. The strategies provided the basic leadership practices required to construct a successful ICT embedded implementation process. Hence, a revised model of leadership that has applicability in the adoption of ICT in Kuwait was developed. The findings provide a better understanding of how a school principal’s leadership practices impact upon the ICT embedding process. Hence, the outcome of this study informs emerging countries, which are also undergoing major change related to ICT, for example, other members of the Cooperation Council for the Arab States of the Gulf. From an educational perspective, this knowledge has the potential to support ICT-based learning environments that will help educational practitioners to effectively integrate ICT into teaching and learning that will facilitate students’ ICT engagement, and prepare them for the ICT development challenges that are associated with the new economy; this is achieved by increasing students’ knowledge and performance. Further, the study offers practical strategies that have been shown to work for school principals leading ICT implementation in Kuwait. These strategies include how to deal with the shortage in schools’ budgets, and the promotion of the ICT vision, as well as developing approaches to build collaborative culture in the schools.

Incident investigation training needs for the Australasian rail industry

A core component for the prevention of re-occurring incidents within the rail industry is rail safety investigations. Within the current Australasian rail industry, the nature of incident investigations varies considerably between organisations. As it stands, most of the investigations are conducted by the various State Rail Operators and Regulators, with the more major investigations in Australia being conducted or overseen by the Australian Transport Safety Bureau (ATSB). Because of the varying nature of these investigations, the current training methods for rail incident investigators also vary widely. While there are several commonly accepted training courses available to investigators in Australasia, none appear to offer the breadth of development needed for a comprehensive pathway. Furthermore, it appears that no single training course covers the entire breadth of competencies required by the industry. These courses range in duration between a few days to several years, and some were run in-house while others are run by external consultants or registered training organisations. Through consultations with rail operators and regulators in Australasia, this paper will identify capabilities required for rail incident investigation and explore the current training options available for rail incident investigators.

A holistic blended design studio model : Exploring and expanding learning opportunities

This book involves a comprehensive study of the learning environment by adopting Grounded Theory methodology in a qualitative comparative way.It explores the limitations and benefits of a face-to-face and a virtual design studio as experienced by architecture students and educators at an Australian university in order to find the optimal combination for a blended environment to enhance the students’ experience. The main outcome:holistic multidimensional blended learning model,that through the various modalities,provides adaptive capacity in a range of settings.The model facilitates learning through self-determination,self-management,and the personalisation of the learning environment. Another outcome:a conceptual design education framework,provides a basic tool for educators to evaluate existing learning environments and to develop new learning environments with enough flexibility to respond effectively to a highly dynamic and increasingly technological world.The provision of a practical framework to assist design schools to improve their educational settings according to a suitable pedagogy that meets today’s needs and accommodates tomorrow’s changes.

Environmental rights or a right to the environment? Exploring the nexus between human rights and environmental protection.

The importance of the environment to the fulfilment of human rights is widely accepted at international law. What is less well-accepted is the proposition that we, as humans, possess rights to the environment beyond what is necessary to support our basic human needs. The suggestion that a human right to a healthy environment may be emerging at international law raises a number of theoretical and practical challenges for human rights law, with such challenges coming from both within and outside the human rights discourse. It is argued that human rights law can make a positive contribution to environmental protection, but the precise nature of the connection between the environment and human rights warrants more critical analysis. This short paper considers the different ways that the environment is conceptualised in international human rights law and analyses the proposition that a right to a healthy environment is emerging. It identifies some of the challenges which would need to be overcome before such a right could be recognised, including those which draw on the disciplines of deep ecology and earth jurisprudence.

Basic education for offenders

ILLITERACY is now increasingly recognised as a serious social problem. UNESCO defines literacy in the following way :- "A person is literate when he has acquired the essential knowledge skills that enable him to engage in all those activities in which literacy is required for effective functioning in his group and community" This is in fact seeing the problem in terms of functional literacy. As the demands of an increasingly industrial society grow, more and more people who are functionally illiterate are appearing. Many do not have the functional skills required to enable them to apply for a job. This inability to obtain work is common among clients of the probation service. Literacy has become so important in our society, that to be unable to read and write causes great feeling of isolation, of being different and inferior, which often leads the illiterate to join a group where this deficiency is unknown and where he can gain some status. This is often a delinquent group.

The development of a supportive care needs assessment tool for Indigenous people with cancer

Background: Little is known about the supportive care needs of Indigenous people with cancer and to date, existing needs assessment tools have not considered cultural issues for this population. We aimed to adapt an existing supportive care needs assessment tool for use with Indigenous Australians with cancer. Methods: Face-to-face interviews with Indigenous cancer patients (n = 29) and five focus groups with Indigenous key-informants (n = 23) were conducted to assess the face and content validity, cultural acceptability, utility and relevance of the Supportive Care Needs Survey - Short Form 34 (SCNS-SF34) for use with Indigenous patients with cancer. Results: All items from the SCNS-SF34 were shortened and changed to use more appropriate language (e.g. the word 'anxiety' was substituted with 'worry'). Seven questions were omitted (e.g. items on death and future considerations) as they were deemed culturally inappropriate or irrelevant and 12 items were added (e.g. accessible transport). Optional instructions were added before the sexual items. The design and response format of the SCNS-SF34 was modified to make it easier to use for Indigenous cancer patients. Given the extensive modifications to the SCNS-SF34 and the liklihood of a different factor structure we consider this tool to be a new tool rather than a modification. The Supportive care needs assessment tool for Indigenous people (SCNAT-IP) shows promising face and content validity and will be useful in informing services where they need to direct their attention for these patients. Conclusions: Indigenous people with cancer have language, customs and specific needs that are not accommodated within the standard SCNS-SF34. Our SCNAT-IP improves acceptability, relevance and face validity for Indigenous-specific concerns. Our SCNAT-IP will allow screening for supportive care needs that are specific to Indigenous cancer patients' and greatly inform targeted policy development and practice.

International students using online information resources to learn : complex experience and learning needs

This paper reports the findings of a qualitative study which investigated 25 international students’ use of online information resources for study purposes at two Australian universities. Using an expanded critical incident approach, the study viewed international students through an information literacy lens, as information-using learners. The findings are presented in two complementary parts: as a word picture that describes their whole experience of using online information resources to learn; and as a tabulated set of critical findings that summarises their associated information literacy learning needs. The word picture shows international students’ resource use as a complex interplay of eight inter-related elements: students; information-learning environment; interactions (with online resources); strengths-challenges; learning-help; affective responses; reflective responses; cultural-linguistic dimensions. In using online resources, the international students experience an array of strengths and challenges, and an apparent information literacy imbalance between their more developed information skills and less developed critical information use. The critical findings about information literacy needs provide a framework for developing an inclusive informed learning approach that responds to international students’ complex information using experiences and needs. While the study is situated in Australia, the findings are of potential interest to educators, information professionals and researchers worldwide who seek to support learning in culturally diverse higher education contexts.

Ageing out of place: health and well-being needs and access to home and aged care services for recently arrived older refugees in Melbourne, Australia

Recently arrived older refugees in resettlement countries are a particularly vulnerable population who face many risks to their health and well-being, and many challenges in accessing services.This paper reports on a project undertaken in Victoria,Australia to explore the needs of older people from 14 recently arrived refugee communities, and the barriers to their receiving health and aged care. Findings from consultations with community workers and service providers highlight the key issues of isolation, family conflict and mental illness affecting older refugees, and point to ways in which policy-makers and service providers can better respond to these small but deserving communities.