Developing a model of care to improve the health and well-being for Indigenous people receiving renal dialysis treatment

The high levels of end-stage renal disease among Indigenous Australians, particularly in remote areas of the country, are a serious public health concern. The magnitude of the problem is reflected in figures from the Australian and New Zealand Transplant and Dialysis Registry that show that Indigenous Australians experience end-stage renal disease at a rate almost 9–10 times higher than other non-Indigenous Australians. A majority of Indigenous Australians have to relocate to receive appropriate renal dialysis treatment. In some Australian states, renal treatment is based on self-care dialysis which allows those Indigenous Australians to be treated back in their community. Evidence clearly shows that reuniting renal patients with community and family improves overall health and well-being for those Indigenous Australians. With the appropriate resources, training, and support, self-care management of renal dialysis treatment is an effective way for Indigenous people with end-stage renal failure to be treated at home. In this context, the study was used to gain insight and further understanding of the impact that end-stage renal disease and renal dialysis treatment has had on the lives of Indigenous community members. The study findings are from 14 individually interviewed people from South East Queensland. Data from the interviews were analysed using a combination of thematic and content analysis. The study methodology was based on qualitative data principles where the Indigenous community members were able to share their experiences and journeys living with end-stage renal disease. Many of the experiences and understanding closely relate to the renal disease pattern and the treatment with other outside influences, such as social, cultural, and environmental influences, all having an equal impact. Each community member’s experience with end-stage renal disease is unique; some manage with family and medical support, while others try to manage independently. From the study, community members who managed their renal dialysis treatment independently were much more aware of their renal health status. The study provides recommendations towards a model of care to improve the health and well-being is based on self-care and self-determination principles.

A framework for successful enterprise systems implementation : preliminary findings from a case study

While critical success factors (CSFs) of enterprise system (ES) implementation are mature concepts and have received considerable attention for over a decade, researchers have very often focused on only a specific aspect of the implementation process or a specific CSF. Resultantly, there is (1) little research documented that encompasses all significant CSF considerations and (2) little empirical research into the important factors of successful ES implementation. This paper is part of a larger research effort that aims to contribute to understanding the phenomenon of ES CSFs, and reports on preliminary findings from a case study conducted at a Queensland University of Technology (QUT) in Australia. This paper reports on an empirically derived CSFs framework using a directed content analysis of 79 studies; from top IS outlets, employing the characteristics of the analytic theory, and from six different projects implemented at QUT.

Getting research data ‘out there’ : collaborative solutions to identifying, describing and making research data more visible

At QUT research data refers to information that is generated or collected to be used as primary sources in the production of original research results, and which would be required to validate or replicate research findings (Callan, De Vine, & Baker, 2010). Making publicly funded research data discoverable by the broader research community and the public is a key aim of the Australian National Data Service (ANDS). Queensland University of Technology (QUT) has been innovating in this space by undertaking mutually dependant technical and content (metadata) focused projects funded by ANDS. Research Data Librarians identified and described datasets generated from Category 1 funded research at QUT, by interviewing researchers, collecting metadata and fashioning metadata records for upload to the Australian Research Data commons (ARDC) and exposure through the Research Data Australia interface. In parallel to this project, a Research Data Management Service and Metadata hub project were being undertaken by QUT High Performance Computing & Research Support specialists. These projects will collectively store and aggregate QUT’s metadata and research data from multiple repositories and administration systems and contribute metadata directly by OAI-PMH compliant feed to RDA. The pioneering nature of the work has resulted in a collaborative project dynamic where good data management practices and the discoverability and sharing of research data were the shared drivers for all activity. Each project’s development and progress was dependent on feedback from the other. The metadata structure evolved in tandem with the development of the repository and the development of the repository interface responded to meet the needs of the data interview process. The project environment was one of bottom-up collaborative approaches to process and system development which matched top-down strategic alliances crossing organisational boundaries in order to provide the deliverables required by ANDS. This paper showcases the work undertaken at QUT, focusing on the Seeding the Commons project as a case study, and illustrates how the data management projects are interconnected. It describes the processes and systems being established to make QUT research data more visible and the nature of the collaborations between organisational areas required to achieve this. The paper concludes with the Seeding the Commons project outcomes and the contribution this project made to getting more research data ‘out there’.

Clinical indicators of quality for Australian residential aged care facilities : establishing reliability, validity, and quality thresholds

Background: In response to the need for more comprehensive quality assessment within Australian residential aged care facilities, the Clinical Care Indicator (CCI) Tool was developed to collect outcome data as a means of making inferences about quality. A national trial of its effectiveness and a Brisbane-based trial of its use within the quality improvement context determined the CCI Tool represented a potentially valuable addition to the Australian aged care system. This document describes the next phase in the CCI Tool.s development; the aims of which were to establish validity and reliability of the CCI Tool, and to develop quality indicator thresholds (benchmarks) for use in Australia. The CCI Tool is now known as the ResCareQA (Residential Care Quality Assessment). Methods: The study aims were achieved through a combination of quantitative data analysis, and expert panel consultations using modified Delphi process. The expert panel consisted of experienced aged care clinicians, managers, and academics; they were initially consulted to determine face and content validity of the ResCareQA, and later to develop thresholds of quality. To analyse its psychometric properties, ResCareQA forms were completed for all residents (N=498) of nine aged care facilities throughout Queensland. Kappa statistics were used to assess inter-rater and test-retest reliability, and Cronbach.s alpha coefficient calculated to determine internal consistency. For concurrent validity, equivalent items on the ResCareQA and the Resident Classification Scales (RCS) were compared using Spearman.s rank order correlations, while discriminative validity was assessed using known-groups technique, comparing ResCareQA results between groups with differing care needs, as well as between male and female residents. Rank-ordered facility results for each clinical care indicator (CCI) were circulated to the panel; upper and lower thresholds for each CCI were nominated by panel members and refined through a Delphi process. These thresholds indicate excellent care at one extreme and questionable care at the other. Results: Minor modifications were made to the assessment, and it was renamed the ResCareQA. Agreement on its content was reached after two Delphi rounds; the final version contains 24 questions across four domains, enabling generation of 36 CCIs. Both test-retest and inter-rater reliability were sound with median kappa values of 0.74 (test-retest) and 0.91 (inter-rater); internal consistency was not as strong, with a Chronbach.s alpha of 0.46. Because the ResCareQA does not provide a single combined score, comparisons for concurrent validity were made with the RCS on an item by item basis, with most resultant correlations being quite low. Discriminative validity analyses, however, revealed highly significant differences in total number of CCIs between high care and low care groups (t199=10.77, p=0.000), while the differences between male and female residents were not significant (t414=0.56, p=0.58). Clinical outcomes varied both within and between facilities; agreed upper and lower thresholds were finalised after three Delphi rounds. Conclusions: The ResCareQA provides a comprehensive, easily administered means of monitoring quality in residential aged care facilities that can be reliably used on multiple occasions. The relatively modest internal consistency score was likely due to the multi-factorial nature of quality, and the absence of an aggregate result for the assessment. Measurement of concurrent validity proved difficult in the absence of a gold standard, but the sound discriminative validity results suggest that the ResCareQA has acceptable validity and could be confidently used as an indication of care quality within Australian residential aged care facilities. The thresholds, while preliminary due to small sample size, enable users to make judgements about quality within and between facilities. Thus it is recommended the ResCareQA be adopted for wider use.

Rethinking global media : creative diversity and media dispersal

Communications media have been central to globalizing processes in modern societies. As technological forms, communication media have long extended the transmission of messages across space in ways that challenge the socio-cultural dimensions of the nation-state and national cultures, and the global communications infrastructure that has developed rapidly since the 1980s has further promoted global information flows and cross-border commercial activity. As institutional and organisational forms through which information and content is produced and distributed, media corporations have been at the forefront of international expansion of their market reach and the development of new sites of production and distribution, and media industries are highly dynamic on a global scale. Finally, as cultural forms, or providers of the informational and symbolic content that is received and used by consumers/audiences/users, global media constitute a core means through which people make sense of events in distant places, and the information and images that they carry are central to the existence of common systems of meaning and understanding across nations, regions and cultures.

Design Led Innovation : exploring the synthesis of needs, technologies and business models

The term Design is used to describe a wide range of activities. Like the term innovation, it is often used to describe both an activity and an outcome. Many products and services are often described as being designed, as they describe a conscious process of linking form and function. Alternatively, the many and varied processes of design are often used to describe a cost centre of an organisation to demonstrate a particular competency. However design is often not used to describe the ‘value’ it provides to an organisation and more importantly the ‘value’ it provides to both existing and future customers. Design Led Innovation bridges this gap. Design Led Innovation is a process of creating a sustainable competitive advantage, by radically changing the customer value proposition. A conceptual model has been developed to assist organisations apply and embed design in a company’s vision, strategy, culture, leadership and development processes.

Improving matching process in social network using implicit and explicit user information

Personalised social matching systems can be seen as recommender systems that recommend people to others in the social networks. However, with the rapid growth of users in social networks and the information that a social matching system requires about the users, recommender system techniques have become insufficiently adept at matching users in social networks. This paper presents a hybrid social matching system that takes advantage of both collaborative and content-based concepts of recommendation. The clustering technique is used to reduce the number of users that the matching system needs to consider and to overcome other problems from which social matching systems suffer, such as cold start problem due to the absence of implicit information about a new user. The proposed system has been evaluated on a dataset obtained from an online dating website. Empirical analysis shows that accuracy of the matching process is increased, using both user information (explicit data) and user behavior (implicit data).

Queer/error : gay media systems and processes of abjection

Gay community media functions as a system with three nodes, in which the flows of information and capital theoretically benefit all parties: the gay community gains a sense of cohesion and citizenship through media; the gay media outlets profit from advertisers’ capital; and advertisers recoup their investments in lucrative ‘pink dollar’ revenue. But if a necessary corollary of all communication systems is error or noise, where—and what—are the errors in this system? In this paper we argue that the ‘error’ in the gay media system is Queerness, and that the gay media system ejects (in a process of Kristevan abjection) these Queer identities in order to function successfully. We examine the ways in which Queer identities are excluded from representation in such media through a discourse and content analysis of The Sydney Star Observer (Australia’s largest gay and lesbian paper). First, we analyse the way Queer bodies are excluded from the discourses that construct and reinforce both the ideal gay male body and the notions of homosexual essence required for that body to be meaningful. We then argue that abject Queerness returns in the SSO’s discourses of public health through the conspicuous absence of the AIDS-inflicted body (which we read as the epitome of the abject Queer), since this absence paradoxically conjures up a trace of that which the system tries to expel. We conclude by arguing that because the ‘Queer error’ is integral to the SSO, gay community media should practise a politics of Queer inclusion rather than exclusion.

Preparing students for international study : the use of technology

About 1.6 million students currently study outside their home country. Despite this, and the fact that Australia, the United States, the United Kingdom and many of the other host countries of international students are themselves extremely culturally diverse communities, business education remains essentially mono-cultural in form and Anglo American in content. Whilst it is true that these international students may want to understand the "Western" way of doing things, they may not be familiar or comfortable with the processes used to facilitate learning. This paper explores a project undertaken to create a tool that provides essential pre-orientation information and advice to students before they leave home. Where cultural adjustment is required, catching students before departure is a very effective time to introduce key information about lifestyle, culture and approaches to teaching and learning that would assist students with the complex and difficult adjustment to studying abroad, so that they could make a smoother transition to their new place of learning. Welcome to Studying Business at QUT is a Data DVD with 19 short videos capturing a student perspective on life and study. Forty percent of the content is related to living and studying and includes sections on accommodation, lifestyle, food and transport etc., and 60% takes an in-depth look at studying business, featuring students and academics talking about issues such as assessment, academic writing and working in groups. This paper outlines the process of developing the DVD and the range of issues addressed.

Playing with picturebooks : postmodernism and the postmodernesque

This thesis traces the influence of postmodernism on picturebooks. Through a review of current scholarship on both postmodernism and postmodern literature it examines the multiple ways in which picturebooks have responded to the influence of postmodernism. The thesis is predominantly located in the field of Cultural and Literary Studies, which informs the ways in which children’s literature is positioned within contemporary culture and how it responds to the influences which shape its production and reception. Cultural and Literary Studies also offers a useful theoretical frame for analysing issues of textuality, ideology, and originality, as well as social and political comment in the focus texts. The thesis utilises the theoretical contributions by, in particular, Linda Hutcheon, Brian McHale, and Fredric Jameson as well as reference to children’s literature studies. This thesis makes a significant contribution to the development of an understanding of the place of the postmodern picturebook within the cultural context of postmodernism. It adds to the field of children’s literature research through an awareness of the (continuing) evolution of the postmodern picturebook particularly as the current scholarship on the postmodernism picturebook does not engage with the changing form and significance of the postmodern picturebook to the same extent as this thesis. This study is significant from a methodological perspective as it draws on a wide range of theoretical perspectives across literary studies, visual semiotics, philosophy, cultural studies, and history to develop a tripartite methodological framework that utilises the methods of postclassical narratology, semiotics, and metafictive strategies to carry out the textual analysis of the focus texts. The three analysis chapters examine twenty-two picturebooks in detail with respect to the ways in which the conventions of narrative are subverted and how dominant discourses are interrogated. Chapter 4: Subverting Narrative Processes includes analysis of narrative point of view, modes of representation, and characters and the problems of identity and subjectivity. Chapter 5: Challenging Truth, History, and Unity examines questions of ontology, the difficulties of representing history, and addresses issues of difference and ‘otherness’. The final textual analysis chapter, Chapter 6: Engaging with Postmodernity, critiques texts which engage with issues of globalisation, mass media, and consumerism. Brief discussion of a further fifteen picturebooks throughout the thesis provides additional support. Children’s texts have a tradition of being both resistant and compliant. Its resistance has made a space for the development of the postmodern picturebook; its compliance is evident in its tendency to take a route around a truly radical or iconoclastic position. This thesis posits that children’s postmodern picturebooks adopt what suits their form and purposes by drawing from and reflecting on some influences of postmodernism while disregarding those that seem irrelevant to its direction. Furthermore, the thesis identifies a shift in the focus of a number of postmodern picturebooks produced since the turn of the twenty-first century. This trend has seen a shift from texts which interrogate discourses of liberal humanism to those that engage with aspects of postmodernity. These texts, postmodernesque picturebooks, offer contradictory perspectives on aspects of society emanating from the rise in global trends mentioned above.

Development sites in the empty city : from picture book to performance

Picturebooks invite performance every time they are read. What happens to them when they’re adapted for live performance? This ongoing practice led research project (2008-) regenerates and transforms picturebook The Empty City (Hachette/Livre 2007) by David Megarrity and Jonathon Oxlade into a live experience. In this rebuilding, interanimation of text and illustration on the picturebook page suddenly open up into a new and complex structure incorporating composition of music, animation, live action, projected image and performing objects. The presenter is the creator of both the source text and writer/composer of the adaptation, providing a unique vantage point that draws on sources from both within and without the creative process up to and including audience reception. From the foundations up, this paper’s focus is on deep, muddy sites of development in the adaptation process, unearthed treasures, and how perceptions of fear and safety push, sway and stress the building of a new performance work for children in content, form and process.

The probability archive : essence, uncertainty, and the ‘Olduvai imperative.’

Starting from a local problem with finding an archival clip on YouTube, this paper expands to consider the nature of archives in general. It considers the technological, communicative and philosophical characteristics of archives over three historical periods: 1) Modern ‘essence archives’ – museums and galleries organised around the concept of objectivity and realism; 2) Postmodern mediation archives – broadcast TV systems, which I argue were also ‘essence archives,’ albeit a transitional form; and 3) Network or ‘probability archives’ – YouTube and the internet, which are organised around the concept of probability. The paper goes on to argue the case for introducing quantum uncertainty and other aspects of probability theory into the humanities, in order to understand the way knowledge is collected, conserved, curated and communicated in the era of the internet. It is illustrated throughout by reference to the original technological 'affordance' – the Olduvai stone chopping tool.

Urban maze : A typological investigation in porous morphology and dynamic pedestrian networks

Mixed use typologies and pedestrian networks are two strategies commonly applied in design of the contemporary city. These approaches, aimed towards the creation of a more sustainalble urban environment, have their roots in the traditional, pre-industrial towns; they characterize urban form, articulating the tension between privaate and public realms through a series of typological variations as well as stimulating commercial activity in the city centre. Arcades, loggias and verandas are just some of the elements which can mediate this tension. Historically they have defined physical and social spaces with particular character; in the contemporary city these features are applied to deform the urban form and create a porous, dynamic morphology. This paper, comparing case studies from Italy, Japan and Australia, investigates how the design of the transition zone can define hybrid pedestrian networks, where a clear distinction between the public and private realms is no longer applicable. Pedestrians use the city in a dynamic way, combining trajectories on the public street with ones on the fringe or inside of the private built environment. In some cases, cities offer different pedestrian network possibilities at different times, as the commercial precints are subject to variations in accessibility across various timeframes. These walkable systems have an impact on the urban form and identity of places, redefining typologies and requiring an in depth analysis through plan, section and elevation diagrams.

Self-management of cancer treatment-related fatigue, nausea, vomiting and oral mucositis in Chinese cancer patients

Background: Treatment-related symptoms continue to place a significant burden on many cancer patients. Many side effects require patients to engage in a range of self-management actions. While some studies have explored self-management of treatment-related side effects in Western settings, very few studies were identified that described the self-management practices of cancer patients in China. Objective: The purposes of this study are to: (1) Investigate Chinese cancer patients. self-management behaviours in dealing with the fatigue, nausea/vomiting and oral mucositis that result from treatment, as well as the perceived effectiveness of these behaviours and related self-efficacy in performing them. (2) Explore factors influencing symptom self-management behaviours using the Cancer Symptom Self-management Framework based on Grey, Knafl and McCorkle.s (2006) self-management framework as a guide. Methods: This study was divided into two phases. Phase One consisted of the translation and modification of two instruments. The adaptation of these instruments to ensure applicability in the Chinese context was achieved through semi-structured interviews with six cancer patients, and content evaluation with eight experienced oncology nurses. A pilot study was conducted with nine cancer patients to trial the questionnaire set in the Chinese context. Based on the results of Phase One, Phase Two involved a cross-sectional survey of Chinese cancer patients undergoing cancer treatment using these instruments. A total of 277 chemotherapy patients with fatigue and/or nausea and vomiting, and 100 radiotherapy patients with oral mucositis were surveyed. Results: Participants in this study reported a variety of self-management behaviours to cope with fatigue, nausea, vomiting and oral mucositis. There are some consistencies as well disparities between strategies that are frequently used and those rated as effective. For fatigue self-management, participants were more likely to use strategies related to rest and sleep, while activity enhancement strategies were rated as achieving higher relief. For nausea and vomiting self-management, dietary modification and taking medication were most frequently used and rated as moderately effective. Psychological strategies were used by more than a third of participants and were rated as mildly effective. Some other infrequently used strategies, such as distraction by keeping busy and acupressure, were rated as moderately effective. For oral mucositis self-management, having soft, bland food and keeping the mouth moisturised were most frequently reported and they were rated as achieving moderate relief. A prescribed mouthwash was used by most but not all participants and brought moderate relief. In general, patients had low-to-moderate self-efficacy in nausea and vomiting self-management behaviours, moderate self-efficacy in fatigue self-management behaviours, and low-to-moderate self-efficacy in oral mucositis self-management behaviours. In terms of the factors influencing symptom self-management, different predictors were identified affecting engagement in fatigue, nausea/vomiting and oral mucositis self-management behaviours. Self-efficacy scores of different behaviours were consistently found to be a positive predictor of the relief level from corresponding behaviours, after controlling for other variables. Perceived social support from health care professionals was identified as an important factor influencing nausea and vomiting self-management behaviours, while neighbourhood support was important for fatigue self-management. In addition, symptom distress was identified as an important factor influencing nausea and vomiting self-management. Conclusion: Similar to reports from overseas, Chinese cancer patients initiate a wide range of self-management behaviours in response to treatment-related side effects. While some behaviours were reported to provide relief, many did not. Given these results, this study has a number of practical implications for health care professionals, particularly in relation to developing tailored self-management programs for fatigue, nausea, vomiting and oral mucositis. Additionally, this study suggests a number of theoretical implications and directions for future research. It is envisaged that these recommendations may pave the way for further studies understanding and promoting cancer symptom self-management in Chinese people affected by cancer.

Good faith in contractual performance and enforcement : Australian doctrinal hurdles

In the ongoing and spirited debate about the relative merits of an obligation of good faith in contractual performance and enforcement, widely divergent views have been expressed about the appropriateness and content of the putative obligation. However, relatively less time has been devoted to discussion of the sparseness of tools available to facilitate doctrinal development and the hurdles necessarily imposed by such limited doctrinal resources. This article seeks to examine the Australian doctrinal position against the backdrop of good faith as it finds application in the wider global context.