The impact of Health Information Technology (I-HIT) scale : the Australian results

One of role of the nurse in the clinical setting is that of coordinating communication across the healthcare team. On a daily basis nurses interact with the person receiving care, their family members, and multiple care providers thus placing the nurse in the central position with access to a vast array of information on the person. Through this nurses have historically functioned as “information repositories”. With the advent of Health Information Technology (HIT) tools there is a potential that HIT could impact interdisciplinary communication, practice efficiency and effectiveness, relationships and workflow in acute care settings \[1]\[3]. In 2005, the HIMSS Nursing Informatics Community developed the IHITScale to measure the impact of HIT on the nursing role and interdisciplinary communication in USA hospitals. In 2007, nursing informatics colleagues from Australia, Finland, Ireland, New Zealand, Scotland and the USA formed a research collaborative to validate the IHIT in six additional countries. This paper will discuss the background, methodology, results and implications from the Australian IHIT survey of over 1100 nurses. The results are currently being analyzed and will be presented at the conference.

Validation of the impact of Health Information Technology (I-HIT) scale : an international collaborative

In 2005, the Healthcare Information Management Systems Society (HIMSS) Nursing Informatics Community developed a survey to measure the impact of health information technology (HIT), the IHIT Scale, on the role of nurses and interdisciplinary communication in hospital settings. In 2007, nursing informatics colleagues from Australia, England, Finland, Ireland, New Zealand, Scotland and the United States formed a research collaborative to validate the IHIT across countries. All teams have completed construct and face validation in their countries. Five out of six teams have initiated reliability testing by practicing nurses. This paper reports the international collaborative’s validation of the IHIT Scale completed to date.

What’em with the apology? : the National Apology to the Stolen Generations two years on

Prime Minister Kevin Rudd’s Apology to Australia’s Stolen Generations, delivered on 13 February 2008, is both personal and political to me just as the people who talk about it make it political and personal through their actions. This paper represents my attempt to turn the gaze through articulating some of my thoughts on the Apology, policy statements (Close the Gap) and the inconsistencies within the leadership of the present governments. I have endeavoured to do this through exploring the articulations of others and by sharing examples and personal experiences. In bringing forth some analysis to the literature, examples and experiences, I reveal the relationships between oppression, white race privilege and institutional privilege and the epistemology that maintains them. In moving from the position of being silent on the Apology, and my political experiences, to speaking about them, I am able to move from the position of object to subject and to gain a form of liberated voice (hooks 1989:9). Furthermore, I am hopeful that it will encourage others to examine their own practices within political parties and governments and to challenge the domination that continues to subjugate Indigenous peoples. It is only through people enacting their responsibilities and making changes in their daily lives and through the institutions and organisations to which they belong (the personal and political), can the Apology move beyond symbolic to action.

Tobacco Control Conference 2009

Personal reflections from Marlene Thompson and Bronwyn Fredericks on the Oceania Tobacco Control Conference 2009: Addressing inequality through tobacco control.

Conference on urban issues

Personal reflections and opinion on the Australian Aboriginal and Torres Strait Islander Studies (AIATSIS) National Indigenous Studies Conference, Perspectives on Urban life: Connections and Reconnections was held in Canberra from 28 September – 1 October 2009.

Analysing Seasonal Health Data

Seasonal patterns have been found in a remarkable range of health conditions, including birth defects, respiratory infections and cardiovascular disease. Accurately estimating the size and timing of seasonal peaks in disease incidence is an aid to understanding the causes and possibly to developing interventions. With global warming increasing the intensity of seasonal weather patterns around the world, a review of the methods for estimating seasonal effects on health is timely. This is the first book on statistical methods for seasonal data written for a health audience. It describes methods for a range of outcomes (including continuous, count and binomial data) and demonstrates appropriate techniques for summarising and modelling these data. It has a practical focus and uses interesting examples to motivate and illustrate the methods. The statistical procedures and example data sets are available in an R package called ‘season’. Adrian Barnett is a senior research fellow at Queensland University of Technology, Australia. Annette Dobson is a Professor of Biostatistics at The University of Queensland, Australia. Both are experienced medical statisticians with a commitment to statistical education and have previously collaborated in research in the methodological developments and applications of biostatistics, especially to time series data. Among other projects, they worked together on revising the well-known textbook "An Introduction to Generalized Linear Models," third edition, Chapman Hall/CRC, 2008. In their new book they share their knowledge of statistical methods for examining seasonal patterns in health.

Philanthropy for Indigenous causes : more than a 'cup of tea'?

In the face of improved First Nation outcomes in many western nations, Australia is still dealing with a seemingly intractable gap between the quality of life of its Aboriginal and Torres Strait Islander peoples and the non-Aboriginal and Torres Strait Islander population. Philanthropy in Australia provides a smaller proportion of funding for community projects than is the case in other countries and Aboriginal and Torres Strait Islander causes have been significantly under - represented as recipients. This paper reports on a qualitative study aimed at understanding the issues affecting the decisions and actions of grantmaking organisations and individuals who wish to support Aboriginal and Torres Strait Islander causes in the current Australian context. The aims were to build on the limited research in this arena, add to the future research agenda and contribute to practice and policy insights for Australia and beyond. The study found that while government funding programs are perceived as output driven, inflexible and dogmatic - ‘a cup of tea mob’- participants see the Australian philanthropic sector as capable of addressing the complex Aboriginal and Torres Strait Islander ‘problem’ with more innovative and independent thinking. From the point of view of contextual impacts, success criteria, barriers, structural imposts and emotional involvement, the practical experience in grantmaking for Indigenous causes of participants in this study reflects that found elsewhere. However the focus of many grantmakers on organisational rather than community capacity and the potentially elitist emphasis on established relationships continues to hamper Aboriginal and Torres Strait Islander access to philanthropic funding in Australia. Further, if the strategic changes currently visible in the sector are unsupported by a depth of policy and a proactive transfer and distribution of skill and knowledge they may be unsustainable.

Stroke education : promising effects on the health beliefs of those at risk

Background: The effect of patient education on reducing stroke has had mixed effects, raising questions about how to achieve optimal benefit. Because past evaluations have typically lacked an appropriate theoretical base, the design of past research may have missed important effects. --------- Method: This study used a social cognitive framework to identify variables that might change in response to education. A mixed design was used to evaluate two approaches to an intervention, both of which included education. Fifty seniors completed a measure of stroke knowledge and beliefs twice: before and after an intervention that was either standard (educational brochure plus activities that were not about stroke) or enhanced (educational brochure plus activities designed to enhance beliefs about stroke). Outcome measures were health beliefs, intention to exercise to reduce stroke, and stroke knowledge. --------- Results: Selected beliefs changed significantly over time but not differentially across conditions. Beliefs that changed were (a) perceived susceptibility to stroke and (b) perceived benefit of exercise to reduce risk. Benefit beliefs, in particular, were strongly and positively associated with intention to exercise. -------- Conclusion: Findings suggest that basic approaches to patient education may influence health beliefs. More effective stroke prevention programs may result from continued consideration of the role of health beliefs in such programs.

Murri Courts : Indigenous Magistrate Courts : communicating for better outcomes

In setting the scene for this paper, it is useful to briefly outline the history of the Queensland legal system. Our legal system was largely inherited from Britain, so it is, therefore, based in European-Western cultural and legal traditions. Alongside this, and over many thousands of years, Australian Indigenous communities devised their own socio-cultural-legal structures. As a result, when Indigenous people are drawn into interactions with our English-based law and court system, which is very different from Aboriginal law, they face particular disadvantages. Problems may include structural and linguistic differences, the complex language of the law and court processes, cultural differences, gender issues, problems of age, communication differences, the formalities of the courtroom, communication protocols used by judges, barristers, and court administrators, and particularly, the questioning techniques used by police and lawyers.

Applied theatre : performing the future

Objective: This paper provides an introduction to applied theatre and performance as a body of practice that may enhance the wellbeing of Indigenous communities. Applied theatre forms are conceptualized along a continuum from ‘performance-oriented’ to ‘participant-oriented’. Participant reflections are reported from a pilot workshop in Papua New Guinea, as a contribution to the evolution of theory and practice of applied theatre for health promotion in Indigenous communities. -------- Methods: Twelve Papua New Guinean nationals engaged in health promotion participated in the workshop. Participants were invited to reflect on the potential application of the theatre forms for their own health promotion practice. The workshop was qualitatively evaluated through a focus group at the conclusion of the workshop. --------- Results: Participants identified specific theatre forms which they could use in their own health promotion practice. Several participants articulated a view that participant-oriented forms were more likely to influence health-related behaviour than performance-oriented forms, in their cultural context. --------- Conclusions: The theatre-for-development literature does not yet clearly articulate how specific theatre forms may be more or less efficacious in terms of influencing health-related behaviour across cultural contexts. More extensive research into this question will yield significant benefits in terms of focusing practice culturally.

Health, endogenous time preference, and inequality : a political economy perspective

We study an overlapping-generations model in which agents' mortality risks, and consequently impatience, are endogenously determined by private and public investment in health care. Revenues allocated for public health care arc determined by a voting process. We find that the degree of substitutability between public and private health expenditures matters for macroeconomic outcomes of the model. Higher substitutability implies a “crowding-out" effect, which in turn impacts adversely on morality risks and impatience leading to lower public expenditures on health care in the political equilibrium. Consequently, higher substitutability is associated with greater polarization in wealth, and long-run distributions that are bimodal.

Narratives of mitigation : sentencing Indigenous criminal defendants in South Australia’s Higher Courts

In their statistical analyses of higher court sentencing in South Australia, Jeffries and Bond (2009) found evidence that Indigenous offenders were treated more leniently than non-Indigenous offenders, when they appeared before the court under similar numerical circumstances. Using a sample of narratives for criminal defendants convicted in South Australia’s higher courts, the current article extends Jeffries and Bond’s (2009) prior statistical work by drawing on the ‘focal concerns’ approach to establish whether, and in what ways, Indigeneity comes to exert a mitigating influence over sentencing. Results show that the sentencing stories of Indigenous and non-Indigenous offenders differed in ways that may have reduced assessments of blameworthiness and risk for Indigenous defendants. In addition, judges highlighted a number of Indigenous-specific constraints that potentially could result in imprisonment being construed as an overly harsh and costly sentence for Indigenous offenders.

Lifting the lifegiving dollar : case samples of creative practice in health and medical research philanthropy

This study aims to stimulate thought, debate and action for change on this question of more vigorous philanthropic funding of Australian health and medical research (HMR). It sharpens the argument with some facts and ideas about HMR funding from overseas sources. It also reports informed opinions from those working, giving and innovating in this area. It pinpoints the range of attitudes to HMR giving, both positive and negative. The study includes some aspects of Government funding as part of the equation, viewing Government as major HMR givers, with particular ability to partner, leverage and create incentives. Stimulating new philanthropy takes active outreach. The opportunity to build more dialogue between the HMR industry and the wider community is timely given the ‘licence to practice’ issues and questioned trust that applies currently somewhat both to science and to the charitable sector. This interest in improving HMR philanthropy also coincides with the launch last year by the Federal Government of Nonprofit Australia Limited (NAL), a group currently assessing infrastructure improvements to the charitable sector. History suggests no one will create this change if Research Australia does not. However, interest in change exists in various quarters. For Research Australia to successfully change the culture of Australian HMR giving, the process will drive the outcomes. Obviously stakeholder buy-in and partners will be needed and the ultimate blueprint for greater philanthropic HMR funding here will not be this document. Instead it will be the one that wears the handprint and ‘mindprint’ of the many architects and implementers interested in promoting HMR philanthropy, from philanthropists to nonprofit peaks to government policy arms. As the African proverb says, ‘If you want to go fast, go alone; but if you want to go far, go with others’.

The role of social capital in reducing negative health outcomes among police officers

This paper investigates the role of social capital on the reduction of short and long run negative health effects associated with stress, as well as indicators of burnout among police officers. Despite the large volume of research on either social capital or the health effects of stress, the interaction of these factors remains an underexplored topic. In this empirical analysis we aim to reduce such a shortcoming focusing on a highly stressful and emotionally draining work environment, namely law enforcement agents who perform as an essential part of maintaining modern society. Using a multivariate regression analysis focusing on three different proxies of health and three proxies for social capital conducting also several robustness checks, we find strong evidence that increased levels of social capital is highly correlated with better health outcomes. Additionally we observe that while social capital at work is very important, social capital in the home environment and work-life balance are even more important. From a policy perspective, our findings suggest that work and stress programs should actively encourage employees to build stronger social networks as well as incorporate better working/home life arrangements.

Bronwyn Fredericks

Bronwyn Fredericks shares her thoughts on citizen advocacy as part of the 1999-2009 celebration of Capricorn Citizen Advocacy Inc.