Prevalence and predictors of advance directives in Australia

Background Advance care planning is regarded as integral to better patient outcomes yet little is known about the prevalence of advance directives in Australia. Aims To determine the prevalence of advance directives (ADs) in the Australian population. Methods A national telephone survey about estate and advance planning. Sample was stratified by age (18-45 and >45 years) and quota sampling occurred based on population size in each State and Territory. Results Fourteen percent of the Australian population has an AD. There is State variation with people from South Australia and Queensland more likely to have an AD than people from other states. Will making and particularly completion of a financial enduring power of attorney are associated with higher rates of AD completion. Standard demographic variables were of limited use in predicting whether a person would have an AD. Conclusions Despite efforts to improve uptake of advance care planning (including ADs), barriers remain. One likely trigger for completing an AD and advance care planning is undertaking a wider future planning process (e.g. making a will or financial enduring power of attorney). This presents opportunities to increase advance care planning but steps are needed to ensure that planning which occurs outside the health system is sufficiently informed and supported by health information so that it is useful in the clinical setting. Variations by State could also suggest that redesign of regulatory frameworks (such as a user-friendly and well publicised form backed by statute) may help improve uptake of ADs.

Principles of goal-directed spatial robot navigation in biomimetic models

Mobile robots and animals alike must effectively navigate their environments in order to achieve their goals. For animals goal-directed navigation facilitates finding food, seeking shelter or migration; similarly robots perform goal-directed navigation to find a charging station, get out of the rain or guide a person to a destination. This similarity in tasks extends to the environment as well; increasingly, mobile robots are operating in the same underwater, ground and aerial environments that animals do. Yet despite these similarities, goal-directed navigation research in robotics and biology has proceeded largely in parallel, linked only by a small amount of interdisciplinary research spanning both areas. Most state-of-the-art robotic navigation systems employ a range of sensors, world representations and navigation algorithms that seem far removed from what we know of how animals navigate; their navigation systems are shaped by key principles of navigation in ‘real-world’ environments including dealing with uncertainty in sensing, landmark observation and world modelling. By contrast, biomimetic animal navigation models produce plausible animal navigation behaviour in a range of laboratory experimental navigation paradigms, typically without addressing many of these robotic navigation principles. In this paper, we attempt to link robotics and biology by reviewing the current state of the art in conventional and biomimetic goal-directed navigation models, focusing on the key principles of goal-oriented robotic navigation and the extent to which these principles have been adapted by biomimetic navigation models and why.

Good Practice Report : Postgraduate Research and Coursework Degrees

Over the past decade, enrolments in postgraduate courses in Australian universities have risen by 34% (or from 258,164 in 2004 to 347,363 in 2013) (uCube, 2014). This substantial growth can be attributed to increased demand for postgraduate coursework as continuing professional education, the expansion of Higher Degrees Research (HDR) intakes, and the development of postgraduate research and coursework degrees in new fields. At the same time, the establishment of the Australian Qualification Framework (AQF) and national Tertiary Education Quality and Standards Agency (TEQSA), as well as the internationalisation of postgraduate education, have brought challenges and opportunities to the sector. During the past five years, the Australian Government Office for Learning and Teaching (OLT) and its predecessor bodies have funded a number of projects and Fellowships on postgraduate coursework and research degrees. They span diverse topics–from entry pathways and research training to supporting international and Indigenous students, examination, scoping studies of new and emergent programs, and effective supervision. In 2014 the OLT commissioned this good practice report to review the grants and fellowships conducted between 2009 and 2014. Encompassing twenty-seven learning and teaching projects and fellowships, the aims of this report include providing universities and academics with an overview of the current state of postgraduate study in Australia and the major influences upon it; a coherent overview of funded projects’ findings and outcomes; and a central point to access good practices, resources and tools in summary form. The objectives of this good practice report are to provide: • A literature review, which contextualises the projects within the Australian and international Higher Education environment, emphasises factors that currently influence postgraduate programs, and highlights challenges and opportunities for the sector. It also explains variations in postgraduate course types and definitions within the Australian Qualification Framework (AQF), and identifies key learning and teaching issues as well as good practices identified in scholarly research and position papers. • A collated overview of the twenty-seven national learning and teaching projects and fellowships on postgraduate coursework and research, including a summary of each project’s aims and objectives, methodologies, outcomes and resources. • A summative index of project characteristics (topics, themes and approaches) and inventory of scholarly research outcomes of the completed projects (publications, reports) as well as resources produced (tools, methods, good practice case studies), and their location (URL Links, references, etc.). • A summary of good practices that have been identified from the literature and the findings of completed projects. • A set of recommendations to address remaining gaps in the field and areas in which further work or development are appropriate. Bringing this work together will help enable university course teams to improve the delivery and development of existing postgraduate courses and to develop new ones, and it will provide academics with an overview of good practices and resources for teaching, supervising and supporting postgraduate students.

Opportunity cost of unavailable surgical instruments in Australian hospitals

Hospitals invest considerable resources organizing operating suites and having surgeons and theatre staff available on an agreed schedule. A common impediment to efficiency is perioperative delay,including delays getting to the operating room or during the operation. Perioperative delays entail significant costs for hospitals,wasting staff time and operating theatre resources. They may also affect patient outcomes; prolonged surgery is a predictor for unanticipated admission following elective ambulatory surgery...

Psychological determinants of motorcycle helmet use among young adults in Cambodia

Cambodian accident statistics show that motivating motorcyclists to make proper use of a safety helmet is a top priority for road safety policy makers. Yet, currently there is no insight whatsoever in the psychological precursors of helmet use in Cambodia. As such, it remains unclear which variables to target by interventions aimed at promoting the use of safety helmets. Therefore, this study adopted a socio-cognitive perspective towards the examination of helmet use in a sample of Cambodian young adults (N = 344). Two theoretical models, i.e., Health Belief Model and Theory of Planned Behaviour were combined and further complemented with two norm-related variables, i.e., descriptive- and personal norm. Based on the results, two important conclusions can be drawn. Firstly, the sample investigated in this study is clearly favourably disposed towards the use of helmets while riding. Secondly, in decreasing order, helmet use behaviour was found to be determined by the following five key-determinants: perceived behavioural control over a specific set of inhibiting situational factors (i.e., mostly when driving short distances, at night, or when dressed up to go out), perceived behavioural control in general, perceived susceptibility, personal norm, and behavioural intentions. Policy makers are recommended to reevaluate their current behavioural change methods for young adults being favourably disposed towards the use of safety helmets. Rather than focussing on motivation-oriented methods, there is a need for strategies that (1) stimulate the translation of good intentions into the desirable behaviour and (2) encourage young adults not to relapse in case they are exposed to risk facilitating circumstances. These implications will be discussed more in detail.

Multi-level neural modelling : an application of object-oriented software engineering

Neu-Model, an ongoing project aimed at developing a neural simulation environment that is extremely computationally powerful and flexible, is described. It is shown that the use of good Software Engineering techniques in Neu-Model’s design and implementation is resulting in a high performance system that is powerful and flexible enough to allow rigorous exploration of brain function at a variety of conceptual levels.

The impact of relaxing music on insomnia-related thoughts and behaviours

Insomnia is a pervasive problem involving poor sleep quality and quantity. Previous research has suggested that music listening can help alleviate insomnia, but exactly how music helps sleep problems has not been determined. A greater understanding of these processes could help practitioners to design more effective music-based insomnia treatments. This randomised controlled trial was designed to assess the influences of nightly music listening on the sleep-related thoughts and behaviours described in Harvey’s (2002) cognitive model of insomnia maintenance. University students, including a range of good and poor sleepers, were randomly assigned to a music listening group or a control group and were assessed before and after a two-week music listening intervention. Measures included a range of self-report scales, each assessing an element of Harvey’s cognitive model. During the intervention, the music listening group was asked to listen to provided music for at least 20 minutes each night. The control group was asked to maintain their regular nightly routines. Results indicated that the music listening group significantly improved on most of the factors theorised to influence sleep quality, although their actual sleep quality did not significantly improve. The control group did not change significantly on any measures. The results of this study suggest that music listening can have positive impacts on a range of factors theorised to influence sleep quality. However, as the music was not shown to actually improve sleep quality, Harvey’s cognitive model explanation of music’s effect on sleep quality may require further investigation.

Reframe QUT's evaluation framework : a case study of planning, policy and positioning leading to educational best practice

Every university in Australia has a set of policies that guide the institution in its educational practices, however, the policies are often developed in isolation to each other. Now imagine a space where policies are evidence-based, refined annually, cohesively interrelated, and meet stakeholders’ needs. Is this happenstance or the result of good planning? Culturally, Queensland University of Technology (QUT) is a risk-averse institution that takes pride in its financial solvency and is always keen to know “how are we going?” With a twenty-year history of annual reporting that assures the quality of course performance through multiple lines of evidence, QUT’s Learning and Teaching Unit went one step further and strategically aligned a suite of policies that take into consideration the needs of their stakeholders, collaborate with other areas across the institution and use multiple lines of evidence to inform curriculum decision-making. In QUT’s experience, strategic planning can lead to policy that is designed to meet stakeholders’ needs, not manage them; where decision-making is supported by evidence, not rhetoric; where all feedback is incorporated, not ignored; and where policies are cohesively interrelated, not isolated. While many may call this ‘policy nirvana’, QUT has positioned itself to demonstrate good educational practice through Reframe, its evaluation framework. In this case, best practice was achieved through the application of a theory of change and a design-led logic model that allows for transition to other institutions with different cultural specificity. The evaluation approach follows Seldin’s (2003) notion to offer depth and breadth to the evaluation framework along with Berk’s (2005) concept of multiple lines of evidence. In summary, this paper offers university executives, academics, planning and quality staff an opportunity to understand the critical steps that lead to strategic planning and design of evidence-based educational policy that positions a university for best practice in learning and teaching.

Seeing it differently: physical education, teacher education and the possibilities of personal construct theory

The celebrated work of Lortie (1975) alerted teacher educators to the extended period of 'apprenticeship' that student teachers have been through before they arrive at teacher education programmes. The subjective implicit theories (Marland, 1992) developed by prospective teachers are shaped by their lifeworld experiences at school and in the case of physical education teachers, their experiences in sport. The biography of physical education teacher education (PETE) students tends to be characterised by ecto-mesomorphic individuals who have been socialised by the rigours of highly competitive sport (Gore, 1990; Macdonald, 1992; Rossi, 1996). We can add to this, the requirements of teacher preparation in physical education which for the most part are dominated by the traditions and rhetoric of the 'natural' bio-physical sciences; largely a legacy of Henry's (1964) work on physical education as an academic discipline, as well as that of Abernathy and Waltz the same year (Abernathy & Waltz, 1964). In the United Kingdom, Curl (1973) further advanced the argument in an attempt to justify human movement as an independent field of study with its own corpus of knowledge. It is little wonder then, that the dominant pedagogical discourse in physical education is, as Tinning (1991) discusses, one of performance pedagogy (see also Hendry, 1986 for an earlier discussion). The knowledge required to support such a discourse could be described as 'official' (Apple, 1993) and it assumes such status by virtue of the power appropriated by and bestowed upon the scientific community in PETE (Macdonald & Tinning, 1995; Sparkes, 1989, 1993). However, there are social reifiers too, and these tend to relate to the social construction of the body (Kirk, 1993; Kirk & Spiller, 1994; Gilroy, 1994) and what Tinning (1985) has termed the Cult of Slenderness. Furthermore the 'slender image' has become a signifier of 'good health'. This is inextricably linked to what might be considered as a health triplex—'exercise = fitness = health' (see Kirk & Colquhoun, 1989; Tinning & Kirk, 1991) which in Australia, underpins curriculum packages such as Daily Physical Education which teachers (often including physical education primary...

Relocating a flood-affected community : good planning or good politics?

Problem, research strategy and findings: On January 10, 2011, the town of Grantham, Queensland (Australia), was inundated with a flash flood in which 12 of the town's 370 residents drowned. The overall damage bill in Queensland was AUD∃2.38 billion (USD∃2.4 billion) with 35 deaths, and more than three-quarters of the state was declared a flood disaster zone. In this study, we focus on the unusual and even rare decision to relocate Grantham in March 2011. The Lockyer Valley Regional Council (LVRC) acquired a 377-hectare (932-acre) site to enable a voluntary swap of equivalent-sized lots. In addition, planning regulations were set aside to streamline the relocation of a portion of the town. We review the natural hazard literature as it relates to community relocation, state and local government documents related to Grantham, and reports and newspaper articles related to the flood. We also analyze data from interviews with key stakeholders. We document the process of community relocation, assess the relocation process in Grantham against best practice, examine whether the process of community relocation can be upscaled and if the Grantham relocation is an example of good planning or good politics. Takeaway for practice: Our study reveals two key messages for practice. Community relocation (albeit a small one) is possible, and the process can be done quickly; some Grantham residents moved into their new, relocated homes in December 2012, just 11 months after the flood. Moreover, the role of existing planning regulations can be a hindrance to quick action; political leadership, particularly at the local level, is key to implementing the relocation.

Evolutionary game design : automated game design comes of age

The "Humies" awards are an annual competition held in conjunction with the Genetic and Evolutionary Computation Conference (GECCO), in which cash prizes totalling $10,000 are awarded to the most human-competitive results produced by any form of evolutionary computation published in the previous year. This article describes the gold medal-winning entry from the 2012 "Humies" competition, based on the LUDI system for playing, evaluating and creating new board games. LUDI was able to demonstrate human-competitive results in evolving novel board games that have gone on to be commercially published, one of which, Yavalath, has been ranked in the top 2.5% of abstract board games ever invented. Further evidence of human-competitiveness was demonstrated in the evolved games implicitly capturing several principles of good game design, outperforming human designers in at least one case, and going on to inspire a new sub-genre of games.

Moral vitalism: Seeing good and evil as real, agentic forces

Moral vitalism refers to a tendency to view good and evil as actual forces that can influence people and events. We introduce a scale designed to assess the belief in moral vitalism. High scorers on the scale endorse items such as “There are underlying forces of good and evil in this world”. After establishing the reliability and criterion validity of the scale (Studies 1, 2a, 2b), we examined the predictive validity of the moral vitalism scale, showing that “moral vitalists” worry about being possessed by evil (Study 3), being contaminated through contact with evil people (Study 4), and forfeiting their own mental purity (Study 5). We discuss the nature of moral vitalism and the implications of the construct for understanding the role of metaphysical lay theories about the nature of good and evil in moral reasoning.

Nurses’ views on the implementation of Individualised Medication Administration Guides in patients with dysphagia in care homes

As conditions such as stroke, cancer, Parkinson's disease and Huntingdon's chorea are commonly found in care homes between 15% and 30% of residents in care homes have been found to have difficulties in swallowing their medicines.To address the difficulties associated with administering medicines to patients who cannot swallow (with dysphagia), Individualised Medication Administration Guides (I-MAGs) were introduced by a specialised pharmacist in Care for Elderly wards in a general hospital in East Anglia. The guides contained detailed information about how to administer each medication and they were individualised to the needs of the patient. The I-MAGs were printed in green forms and attached to the medication chart in order to be used in conjunction with it. The ward nurses reported an increase in their confidence when administering medication when I-MAGs were present in the ward. Some patients with I-MAG were discharged to care homes where the I-MAG might have been equally useful. However, the design of such guides is not known to be suitable for care homes environment where they have never been used before. This study aims to explore the opinions of nurses and carers within care homes on the relevance and acceptability of individualised medication administration guides for patients with dysphagia (PWD).

Medicines related dysphagia in primary care: The prevalence of and impact on community pharmacists

Dysphagia is a common and problematic symptom characterised by varying degrees of difficulty swallowing food, fluids and medicines of differing consistencies. International primary care based studies have identified that between 1 in 4 and 1 in 5 patients have some form of dysphagia, it can affect medicines taking behaviour and healthcare professionals are largely unaware of this1,2. Similar research has not been undertaken in the UK. Adherence related pharmacy based services in the UK provide an opportunity for community pharmacists to identify the problem and facilitate better medicines use. The aim of this pilot study was to estimate the level of patient reported dysphagia in older persons using community pharmacies in the UK, describe how it affects their medicine taking behaviour and identify whether advanced pharmacy services are related to improved awareness of this.

‘Not a criminal in the classic sense': @DrRimmer on the sentencing of Jono Moylan #leardblockade #standwithjono

On July 25, 2014, Justice David Davies sentenced Jonathan Moylan at the Supreme Court of New South Wales for a breach of section 1041E (1) of the Corporations Act 2001 (Cth). The ruling is a careful and deliberate decision, showing equipoise. Justice Davies has a reputation for being a thoughtful and philosophical adjudicator. The judge convicted and sentenced Moylan to imprisonment for 1 year and 8 months. The judge ordered that Moylan be “immediately released upon giving security by way of recognisance in the sum of $1000 to be of good behaviour for a period of 2 years commencing today”.