Australia’s first Allied Health Prescribing Program - exploring participants' perspectives on the study program's learning objectives

BACKGROUND The Queensland University of Technology in collaboration with Queensland Health pioneered development of the Allied Health Prescribing Training Program to assist allied health professionals (AHPs) to competently prescribe medicines within their scope of practice. The study program consisted of two modules: Introduction to Clinical Therapeutics for Prescribers and Prescribing and Quality Use of Medicines. METHODS Pre- and post- surveys were developed for both modules. Key themes explored were understanding and confidence in selecting therapeutic choices for patients. For module 2 the learning objectives for safe and effective prescribing were investigated. Data were collected from participants in weeks one and thirteen of the modules via online surveys. RESULTS In the pre-module survey for the first module, participants had a limited degree of understanding and confidence regarding safe and effective use of medicines and appropriate therapeutic choices for managing patients, particularly for complex patients. This improved significantly in the post-module survey. In the pre-module survey for module 2, participants had a moderate degree of understanding and confidence regarding various prescribing learning objectives (including safe and effective prescribing, professional, legal and ethical aspects, communicating medication orders, prescribing safely in their select areas of practice, prescribing safely for complex patients in their area of practice). This increased significantly in the post-module survey. DISCUSSION This training program was implemented to develop a framework of knowledge and skills for AHPs to undertake a prescribing role. The program delivered an increase in participants’ knowledge in the key prescribing areas; and increased participants’ confidence in prescribing safely for patients and for complex patients in their select practice areas. An important aspect of this program was inclusion of prescribing–related activities under supervision of a designated medical practitioner. In conclusion, this educational program for Queensland Health AHP prescribers was successfully developed and is in the final stages of delivery.

Management objectives of Queensland fisheries: Putting the horse before the cart

A review of future management arrangements for the Queensland East Coast Trawl fishery was undertaken in 2010 to develop a management plan for the next 10 years. A key question raised at the start of the review process was: what should the management plan achieve? As with fisheries management in most countries, multiple management objectives were implicit in policy statements, but were poorly specified in some areas (particularly social objectives) and strongly identified in others (e.g., an objective of sustainability). As a start to the management review process, an analysis of what objectives the management system should aim to achieve was undertaken. A review of natural resource management objectives employed internationally was used to develop a candidate list, and the objectives most relevant to the fishery were short-listed by a scientific advisory group. Additional objectives specific to Queensland fisheries management, but not identified in the international review, were also identified and incorporated into the objective set. The relative importance of the different objectives to different stakeholder groups was assessed using the Analytic Hierarchy Process. As with other studies, the relative importance of the different objectives varied both within and between the different stakeholder groups, although general trends in preferences were observed.

Social objectives of fisheries management: What are managers' priorities?

Increasingly, social considerations are having an influence on fisheries policy as well as day-to-day management decision making. Social objectives, unlike economic or conservation objectives, are often poorly defined in fisheries policy, providing substantial leeway for managers to develop management plans in response to the perceived importance of different social outcomes, and potential inconsistencies between different fisheries and jurisdictions. In this paper, through a literature review and workshop with managers across different Australian jurisdictions, we develop a set of social objectives that may be applicable in Australian fisheries. We assess the importance of these different objectives using the Analytic Hierarchy Process, and find considerable diversity in opinion as to which social objectives fisheries management should prioritise to achieve. This diversity of opinion is not directly related to jurisdiction, but does seem related to the context and social environment in which fisheries managers are operating.

Selecting and assessing social objectives for Australian fisheries management

This paper details Australian research that developed tools to assist fisheries managers and government agencies in engaging with the social dimension of industry and community welfare in fisheries management. These tools are in the form of objectives and indicators. These highlight the social dimensions and the effects of management plans and policy implementation on fishing industries and associated communities, while also taking into account the primacy of ecological imperatives. The deployment of these objectives and indicators initially provides a benchmark and, over the life of a management plan, can subsequently be used to identify trends in effects on a variety of social and economic elements that may be objectives in the management of a fishery. It is acknowledged that the degree to which factors can be monitored will be dependent upon resources of management agencies, however these frameworks provide a method for effectively monitoring and measuring change in the social dimension of fisheries management.Essentially, the work discussed in this paper provides fisheries management with the means to both track and begin to understand the effects of government policy and management plans on the social dimension of the fishing industry and its associated communities. Such tools allow the consideration of these elements, within an evidence base, into policy arrangements, and consequently provide an invaluable contribution to the ability to address resilience and sustainability of fishing industries and associated communities.

Comparison of Optimum Reactive Power Schedule with Different Objectives Using LP Technique

Three algorithms for reactive power optimization are proposed in this paper with three different objective functions. The objectives in the proposed algorithm are to minimize the sum of the squares of the voltage deviations of the load buses, minimization of sum of squares of voltage stability L-indices of load buses (:3L2) algorithm, and also the objective of system real power loss (Ploss) minimization. The approach adopted is an iterative scheme with successive power flow analysis using decoupled technique and solution of the linear programming problem using upper bound optimization technique. Results obtained with all these objectives are compared. The analysis of these objective functions are presented to illustrate their advantages. It is observed comparing different objective functions it is possible to identify critical On Load Tap Changers (OLTCs) that should be made manual to avoid possible voltage instability due to their operation based on voltage improvement criteria under heavy load conditions. These algorithms have been tested under simulated conditions on few test systems. The results obtained on practical systems of 24-node equivalent EHV Indian power network, and for a 205 bus EHV system are presented for illustration purposes.

Reactive power optimization with different objectives in large power systems including HVDC systems and FACTS devices

Present day power systems are growing in size and complexity of operation with inter connections to neighboring systems, introduction of large generating units, EHV 400/765 kV AC transmission systems, HVDC systems and more sophisticated control devices such as FACTS. For planning and operational studies, it requires suitable modeling of all components in the power system, as the number of HVDC systems and FACTS devices of different type are incorporated in the system. This paper presents reactive power optimization with three objectives to minimize the sum of the squares of the voltage deviations (ve) of the load buses, minimization of sum of squares of voltage stability L-indices of load buses (¿L2), and also the system real power loss (Ploss) minimization. The proposed methods have been tested on typical sample system. Results for Indian 96-bus equivalent system including HVDC terminal and UPFC under normal and contingency conditions are presented.

The IRYSS-COPD appropriateness study: objectives, methodology, and description of the prospective cohort

Background: Patients with chronic obstructive pulmonary disease (COPD) often experience exacerbations of the disease that require hospitalization. Current guidelines offer little guidance for identifying patients whose clinical situation is appropriate for admission to the hospital, and properly developed and validated severity scores for COPD exacerbations are lacking. To address these important gaps in clinical care, we created the IRYSS-COPD Appropriateness Study. Methods/Design: The RAND/UCLA Appropriateness Methodology was used to identify appropriate and inappropriate scenarios for hospital admission for patients experiencing COPD exacerbations. These scenarios were then applied to a prospective cohort of patients attending the emergency departments (ED) of 16 participating hospitals. Information was recorded during the time the patient was evaluated in the ED, at the time a decision was made to admit the patient to the hospital or discharge home, and during follow-up after admission or discharge home. While complete data were generally available at the time of ED admission, data were often missing at the time of decision making. Predefined assumptions were used to impute much of the missing data. Discussion: The IRYSS-COPD Appropriateness Study will validate the appropriateness criteria developed by the RAND/UCLA Appropriateness Methodology and thus better delineate the requirements for admission or discharge of patients experiencing exacerbations of COPD. The study will also provide a better understanding of the determinants of outcomes of COPD exacerbations, and evaluate the equity and variability in access and outcomes in these patients.

Survey of the shrimp stocks of the Sierra Leone inshore shelf : a summary report outlining objectives, observations and recommendations on the status of the Sierra Leone shrimp fishery

This report gives the species and catch-rates per hour of some commercial shrimp species caught in the course of a short survey of inshore shelf fishing grounds. Species seen in significant quantities were: Parapenneopsis atlantica, Parapenaeus longirostris, Penaeus kerathurus and Penaeus duorarum notialis