General practice coordinated chronic disease management to reduce avoidable hospital admission

Chronic disease accounts for about 80 per cent of the total disease burden in Australia, and its management accounts for 70 per cent of all current health expenditure.1 Effective prevention and management of chronic disease requires a coordinated approach between primary health care, acute care services, and the patients.2 However, what is not clear is whether improvements in primary healthcare management can have a clear benefit in the cost of care of patients with chronic disease. We recently completed a pilot study in rural Western Australia to ascertain the feasibility of a coordinated general practice-based approach to managing chronic respiratory and cardiovascular conditions, and to determine the direct cost savings to the public insurer through reduction in avoidable hospital admission. The aim of this correspondence is to share our preliminary findings and encourage debate on how such a project may be scaled up or adapted to other primary healthcare settings.

An entrepreneurial music industry education in secondary schooling: The emerging professional learning model

There is widespread agreement that entrepreneurial skills are crucial for young people today, yet there are few studies of high school students engaging in entrepreneurship education that might prepare them for music industry careers. This study has been developed in response to these challenges. It explores a group of high school students (15 – 17 years) who alongside their teacher, have co-designed, developed and driven a new business venture, Youth Music Industries (YMI) since 2010. This venture staged cycles of differently scaled events featuring young artists for a young audience. The project was designed to give students a real business situation for developing their project management skills and a broader understanding of working in the music industry. Informed by concepts of social capital and communities of practice, the study examines the process of learning with and through others. This high-stakes environment increased their sense of presence and participation and made it possible for these young people to distribute expertise and learn from each other in a reciprocal and more democratic way. The ongoing success of this organisation can be attributed to the entrepreneurial competencies students developed. The resulting model and design principles talk to an ongoing challenge that has been identified in music education, and creative industries more generally. These principles offer a way forward for other music and creative industries educators or researchers interested in developing models of, and designs for, nurturing an entrepreneurial mindset.

Mandatory Reporting Laws and the Identification of Severe Child Abuse and Neglect

This book provides the first comprehensive international coverage of key issues in mandatory reporting of child abuse and neglect. The book draws on a collection of the foremost scholars in the field, as well as clinicians and practice-based experts, to explore the nature, history, impact and justifiability of mandatory reporting laws, their optimal form, legal and conceptual issues, and practical issues and challenges for reporters, professional educators and governments. Key issues in non-Western nations are also explored briefly to assess the potential of socio-legal responses sex trafficking, forced child labour and child marriage. The book is of particular value to policy makers, educators and opinion leaders in government departments dealing with children, and to professionals and organisations who work with children. It is also intended to be a key authority for researchers and teachers in the fields of medicine, nursing, social work, education, law, psychology, health and allied health fields.

Under this Sky: Logan's Musical Celebration

A creative practice as research, UNDER THIS SKY is the latest investigation in a 12-year study into the “QMF Model”, an application of principles of community and cultural practice that generates large-scale, music spectacle events that derive their narrative and expression from the communities in which they are performed. UNDER THIS SKY is a large-scale musical specially commissioned for the city of Logan (Queensland) as the signature work of the 2015 Queensland Musical Festival. The investigation centres around the capacity of the “QMF Model” to engage with performers and musicians of Logan and then, through community consultation, create a narrative based on idiosyncratic stories and themes that would culminate in a performance event in August 2015. Previous creative projects, Boomtown (Gladstone), Behind the Cane (Bowen) and The Road We’re On (Charleville), were conducted in relatively small communities, Gladstone being the largest. In UNDER THIS SKY, the model is being tested in a large metropolitan city (Logan – 300,000). The core principles of CACD (community arts and cultural development) are being interrogated and adapted to fit this large-scale, whole of community environment. The purpose is to refine and further validate the “QMF Model” as a viable and effective process for community/artistic partnerships. Since February 2014, professional artists and managers have facilitated and shaped the work, up-skilling performers over a periods of 12 months, developing new relationships and creating opportunities for participation at all levels of experience. The research methodology involved creative practice through a continuous cycle of action, reflection, adaptation and application.

Stone baby: An exploration of trembling and its potential for visual art

Informed by Kristeva's formulation of affect and Winnicott's Holding Environment, this practice-led visual art project is an exploration into how sensitivity to the physical sensation of trembling can sustain a creative practice. Building upon this is a further enquiry into what the significance of the affective experience of trembling is for an ethics of affect in contemporary art. I have done this through object and video-based installations informed by my own experience of trembling. This has been further informed by the work of artists like Louise Bourgeois, Dennis Del Favero and Willie Doherty. The creative outcomes contribute to the discourse around ethical responses to affect by extending and developing on the works of these artists.

Disjecta: Material representations of an Indigenous and immigrant cultural legacy

This practice-led research explores family history and the on-going influence of cultural legacy on the individual and the artist. Homi Bhabha theorises that identity vacillates through society, shifting and changing form to create disjunctive historical spaces – spaces of slippage that allow for new narratives and understandings to occur. Using the notion of disjuncture that became apparent in this research, the practice outcomes seek to visualise my families' sometimes-occulted history at the intersection of euro-centric and Indigenous ideologies. Researched archival materials, government documents, interviews, collected objects and family photo-albums became primary source data for studio-based explorations. Scanners, glitch apps and photo-hacking were used to navigate through these materials, providing opportunities for photographic punctum and creating metaphors for the connections and disconnections that shape our sense of self.

Authentically ambiguous, credibly anonymous: Perceptually reframing the personal narrative towards effective persuasion in aggressive human rights contexts

Testing the strategies of discourse and materiality, this practice-based and practice-led research experiments with how anonymous storytelling by vulnerable communities, like that of the sexual minorities and their allies in Malaysia, can better speak to their human rights issues without further subjecting them to personal attacks and targetted persecution. The research identifies the critical role of the voice in lending authenticity and credibility to first person narratives; and contextual credibility as a form of credibility which personal stories naturally aspire to achieve with audiences. Adopting a discursive view of persuasion and recognising too that the power of persuasion may in effect lie with those who receive these stories rather than with those who tell them, the insights and knowledge gained from the research informed the development of the field output, Persuasive Storytelling by Vulnerable Communities in Aggressive Contexts: A Human Rights Communication Framework.

Scenographic practice in contemporary chamber theatre

This research study explores the practice of scenography in contemporary chamber theatre. The practice-led approach allowed for the exploration of theoretical insights around scenography (the arrangement of the performance space, lighting, sound, design, objects and performers) in chamber theatre, directly resulting in the creation and staging of a new theatre work, 'A Tribute of Sorts'. The production was directed by the researcher and staged in two professional theatre companies, Queensland Theatre Company and La Boite Theatre Company in Queensland, Australia. The study investigated if the scenographic components of the chamber theatre performance could be employed as a machine that operates according to its own logic of operations, psycho-plastic manipulations, and metatheatricality. By doing so, testing if the scenography becomes a dramaturgy that contributes to spectorial meaning-making in and of itself.

The intestinal microbiome in human disease and how it relates to arthritis and spondyloarthritis

Humans and microbes have developed a symbiotic relationship over time, and alterations in this symbiotic relationship have been linked to several immune mediated diseases such as inflammatory bowel disease, type 1 diabetes and spondyloarthropathies. Improvements in sequencing technologies, coupled with a renaissance in 16S rRNA gene based community profiling, have enabled the characterization of microbiomes throughout the body including the gut. Improved characterization and understanding of the human gut microbiome means the gut flora is progressively being explored as a target for novel therapies including probiotics and faecal microbiota transplants. These innovative therapies are increasingly used for patients with debilitating conditions where conventional treatments have failed. This review discusses the current understanding of the interplay between host genetics and the gut microbiome in the pathogenesis of spondyloarthropathies, and how this may relate to potential therapies for these conditions.

Speaking of supervision: A dialogic approach to building higher degree research supervision capacity in the creative arts

In the emergent field of creative practice higher degrees by research, first generation supervisors have developed new models of supervision for an unprecedented form of research that combines creative practice and written thesis. In a national research project, entitled 'Effective supervision of creative practice higher research degrees', we set out to capture and share early supervisors' insights, strategies and approaches to supporting their creative practice PhD students. From the insights we gained during the early interview process, we expanded our research methods in line with a distributed leadership model and developed a dialogic framework. This led us to unanticipated conclusions and unexpected recommendations. In this study, we primarily draw on philosopher and literary theorist Mikhail Bakhtin's dialogics to explain how giving precedence to the voices of supervisors not only facilitated the articulation of dispersed tacit knowledge, but also led to other 20 discoveries. These include the nature of supervisors' resistance to prescribed models, policies and central academic development programmes; the importance of polyvocality and responsive dialogue in enabling continued innovation in the field; the benefits to supervisors of reflecting, discussing and sharing practices with colleagues; and the value of distributed leadership and dialogue to academic development and supervision capacity building in research education.

Surface materials and aspects of care: A study in modes of being in a visual art practice

Through creative practice and written research, this thesis explores the peculiar qualities of surface materials, revealing a broader ethos of practice which I identify as care. I propose that care arises as a mode of being between artist and work, work and beholder, and between the parts of the work. The thesis situates the art practice within an ethical framework, premised on, but extending, Heidegger's ontological equation of care with being. The original contribution is in the claim that the particular qualities of worldly matter generate the terms for care as a particular mode of engagement that is reciprocal and intransitive.

How to develop an online community for pre-service and early career teachers

This paper contributes a number of design principles for developing large-scale online communities of pre-service and early career teachers (PS&ECTs). It presents the paradigms of connected learning, networked learning and communities of practice and contrasts them. It describes the potential for online communities to meet the needs of PS&ECTs and it identifies gaps that exist within certain types of existing online communities that currently support PS&ECTs. The paper proposes design principles for a new type of online community for PS&ECTs. These principles are drawn from the literature and from the preliminary outcomes of a pilot study.

Cognitive deficits and the Paced Auditory Serial Addition Test performance among patients with multiple sclerosis

Multiple sclerosis (MS) is a chronic, inflammatory disease of the central nervous system, characterized especially by myelin and axon damage. Cognitive impairment in MS is common but difficult to detect without a neuropsychological examination. Valid and reliable methods are needed in clinical practice and research to detect deficits, follow their natural evolution, and verify treatment effects. The Paced Auditory Serial Addition Test (PASAT) is a measure of sustained and divided attention, working memory, and information processing speed, and it is widely used in MS patients neuropsychological evaluation. Additionally, the PASAT is the sole cognitive measure in an assessment tool primarly designed for MS clinical trials, the Multiple Sclerosis Functional Composite (MSFC). The aims of the present study were to determine a) the frequency, characteristics, and evolution of cognitive impairment among relapsing-remitting MS patients, and b) the validity and reliability of the PASAT in measuring cognitive performance in MS patients. The subjects were 45 relapsing-remitting MS patients from Seinäjoki Central Hospital, Department of Neurology and 48 healthy controls. Both groups underwent comprehensive neuropsychological assessments, including the PASAT, twice in a one-year follow-up, and additionally a sample of 10 patients and controls were evaluated with the PASAT in serial assessments five times in one month. The frequency of cognitive dysfunction among relapsing-remitting MS patients in the present study was 42%. Impairments were characterized especially by slowed information processing speed and memory deficits. During the one-year follow-up, the cognitive performance was relatively stable among MS patients on a group level. However, the practice effects in cognitive tests were less pronounced among MS patients than healthy controls. At an individual level the spectrum of MS patients cognitive deficits was wide in regards to their characteristics, severity, and evolution. The PASAT was moderately accurate in detecting MS-associated cognitive impairment, and 69% of patients were correctly classified as cognitively impaired or unimpaired when comprehensive neuropsychological assessment was used as a "gold standard". Self-reported nervousness and poor arithmetical skills seemed to explain misclassifications. MS-related fatigue was objectively demonstrated as fading performance towards the end of the test. Despite the observed practice effect, the reliability of the PASAT was excellent, and it was sensitive to the cognitive decline taking place during the follow-up in a subgroup of patients. The PASAT can be recommended for use in the neuropsychological assessment of MS patients. The test is fairly sensitive, but less specific; consequently, the reasons for low scores have to be carefully identified before interpreting them as clinically significant.

VG07023 Driving better vegetable irrigation through profitable practice change

Despite recent flooding in eastern Australia, the availability/quality of irrigation water is a long-term issue for Australian vegetable growers. To survive, producers are told to implement new technologies. However, there is often little practical information investigating which improvements could make a real difference, and keep production profitable. In an Horticulture Australia Ltd three year project, scientists from the Department of Employment, Economic Development and Innovation (QLD), CSIRO, Department of Industry and Investment (NSW), and the National Centre for Engineering in Agriculture, evaluated practical irrigation improvements. We conducted experiments and case studies on farms in southern Queensland and Riverina vegetable districts, with over 100 extension events, including irrigation workshops, conferences, and field days.

Transdisciplinary collaboration in wound care research

The highly complex disorder of chronic wounds is a significant problem. Information is often lacking, dynamically changing, or contradictory and thus acts to impede the progression of research and its translation into clinical care. Transdisciplinary collaboration may play an important role in chronic wound research, permitting key stakeholders with a single, central goal to take a unified approach towards addressing the problem. While transdisciplinary collaboration is not a new concept, its implementation within chronic wound research is relatively new. This is because the research area is still largely dominated by single-discipline researchers or by multiple disciplines working in isolation. Transdisciplinary research is a transcending approach, requiring a greater level of understanding between disciplines and may represent the next leap forward in wound care research. This approach necessitates a deeper understanding by all team members of the co-disciplines involved; where key stakeholders are better equipped to respond to dynamic changes and problems that arise in chronic wound research. In this paper, we illustrate what a transdisciplinary approach in wound care research may entail, with the ultimate goal of such an undertaking to improve understanding of the complexities of wound care, which could lead to potential benefits in wound management.