Hospital infection control units: Staffing, costs, and priorities

Background: This article describes infection prevention and control professionals’ (ICPs’) staffing levels, patient outcomes, and costs associated with the provision of infection prevention and control services in Australian hospitals. A secondary objective was to determine the priorities for infection control units. Methods: A cross-sectional study design was used. Infection control units in Australian public and private hospitals completed a Web-based anonymous survey. Data collected included details about the respondent; hospital demographics; details and services of the infection control unit; and a description of infection prevention and control-related outputs, patient outcomes, and infection control priorities. Results: Forty-nine surveys were undertaken, accounting for 152 Australian hospitals. The mean number of ICPs was 0.66 per 100 overnight beds (95% confidence interval, 0.55-0.77). Privately funded hospitals have significantly fewer ICPs per 100 overnight beds compared with publicly funded hospitals (P < .01). Staffing costs for nursing staff in infection control units in this study totaled $16,364,392 (mean, $380,566). Infection control units managing smaller hospitals (<270 beds) identified the need for increased access to infectious diseases or microbiology support. Conclusion: This study provides valuable information to support future decisions by funders, hospital administrators, and ICPs on service delivery models for infection prevention and control. Further, it is the first to provide estimates of the resourcing and cost of staffing infection control in hospitals at a national level. Copyright

How does Australian diabetic foot screening rate on an international Stage?

Background From the conservative estimates of registrants with the National Diabetes Supply Scheme, we will be soon passing 1.1 Million Australians affected by all types of diabetes. The diabetes complications of foot ulceration and amputation are costly to all. These costs can be reduced with appropriate prevention strategies, starting with identifying people at risk through primary care diabetic foot screening. However, levels of diabetic foot screening in Australia are difficult to quantify. Methods This presentation reports on foot screening rates as recorded in the academic literature, national health surveys and national database reports. The focus is on type 1 and type 2 diabetes in adults, and not gestational diabetes or children. Literature searches included diabetic foot screening that occurred in the primary care setting for populations over 2000 people from 2002 to 2014. Searches were performed using Medline and CINAHL as well as internet searches of OECD health databases. The primary outcome measure was foot -screening rates as a percentage of adult diabetic population. Results The lack of a national diabetes database and register hampers efforts to analyse diabetic foot screening levels. The most recent and accurate level for Australian population review was in the AUSDIAB (Australian Diabetes and lifestyle survey) from 2004. This survey reported screening in primary care to be as low as 50%. Countries such as the United Kingdom and United States of America report much higher rates of foot screening (67-88%) using national databases and web based initiatives that involve patients and clinicians. Conclusions Australian rates of diabetic foot screening in primary care centres is ambiguous. Uptake of national registers, incentives and web based systems improve levels of diabetic foot assessment which are the first steps to a healthier diabetic population.

SECA: SNP effect concordance analysis using genome-wide association summary results

The genomics era provides opportunities to assess the genetic overlap across phenotypes at the measured genotype level; however, current approaches require individual-level genome-wide association (GWA) single nucleotide polymorphism (SNP) genotype data in one or both of a pair of GWA samples. To facilitate the discovery of pleiotropic effects and examine genetic overlap across two phenotypes, I have developed a user-friendly web-based application called SECA to perform SNP effect concordance analysis using GWA summary results. The method is validated using publicly available summary data from the Psychiatric Genomics Consortium.

Investigating the factors influencing the adoption of m-banking: A cross cultural study

Purpose Little is known about the adoption of mobile banking technologies in emerging Asian economies. This paper aims to empirically examine the motivators that influence a consumer’s intentions to use mobile banking. Design/methodology/approach A web-based survey was employed to collect data from 348 respondents, split across Thailand and Australia. Data were analyzed by employing exploratory and confirmatory factor analyses, path and invariance analyses. Findings The findings indicate that for Australian consumers, perceived ease of use, perceived usefulness and perceived risk were the primary determinants of mobile banking adoption. For Thai consumers, the main factors were perceived usefulness, perceived risk and social influence. National culture was found to impact key antecedents that lead to adoption of m-banking. Research limitations/implications The actual variance explained by our study’s model was higher in Australia (59.3%) than for Thailand (23.8%), suggesting future research of m-banking adoption in emerging Asian cultures. Practical implications We identify the important factors consumers consider when adopting m-banking. The findings of this research give banking organisations a foundational model that can be used to support m-banking implementation. Originality/value Our study is perhaps the first to examine and compare the intention to adopt m-banking across Thai and Australian consumers, and responds to calls for additional research that generalises m-banking and m-services acceptance across cultures. This study has proposed and validated additional constructs that are not present in the original SST Intention to Use model.

Competitive Smart Cities through Healthy Decision-making

This chapter examines the challenges and opportunities associated with planning for competitive, smart and healthy cities. The chapter is based on the assumptions that a healthy city is an important prerequisite for a competitive city and a fundamental outcome of smart cities. Thus, it is preeminent to understand the planning decision support system based on local determinants of health, economic and social factors. One of the major decision support systems is e-health and this chapter will focus on the role of e-health planning, by utilising web-based geographic decision support systems. The proposed novel decision support system would provide a powerful and effective platform for stakeholders to access online information for a better decision-making while empowering community participation. The chapter also highlights the need for a comprehensive conceptual framework to guide the decision process of planning for healthy cities in association with opportunities and limitations. In summary, this chapter provides the critical insights of using information science-based framework and suggest online decision support methods, as part of a broader e-health approach for creating a healthy, competitive and smart city.

Determining the drivers of m-banking adoption: A cross cultural study

This study empirically examines the motivators that influence a consumer’s intentions to use mobile banking. A web-based survey was employed to collect data from 348 respondents, split across Thailand and Australia. Data were analysed by employing exploratory and confirmatory factor analyses, path and invariance analyses. The findings indicate that for Australian consumers, perceived ease of use, perceived usefulness and perceived risk were the primary determinants of mobile banking adoption. For Thai consumers, the main factors were perceived usefulness, perceived risk and social influence. National culture was found to impact key antecedents that lead to adoption of m-banking. Interestingly, the actual variance explained by this study’s model was higher in Australia than for Thailand, suggesting future research of m-banking adoption in emerging Asian cultures. The findings of this research give banking organisations a foundational model that can be used to support m-banking implementation. This study is perhaps the first to examine and compare the intention to adopt m-banking across Thai and Australian consumers, and responds to calls for additional research that generalises m-banking and m-services acceptance across cultures. This study has proposed and validated additional constructs that are not present in the original SST Intention to Use model.

Visualization tools for high angular resolution diffusion imaging

There is a major effort in medical imaging to develop algorithms to extract information from DTI and HARDI, which provide detailed information on brain integrity and connectivity. As the images have recently advanced to provide extraordinarily high angular resolution and spatial detail, including an entire manifold of information at each point in the 3D images, there has been no readily available means to view the results. This impedes developments in HARDI research, which need some method to check the plausibility and validity of image processing operations on HARDI data or to appreciate data features or invariants that might serve as a basis for new directions in image segmentation, registration, and statistics. We present a set of tools to provide interactive display of HARDI data, including both a local rendering application and an off-screen renderer that works with a web-based viewer. Visualizations are presented after registration and averaging of HARDI data from 90 human subjects, revealing important details for which there would be no direct way to appreciate using conventional display of scalar images.

Implementing a holistic process for embedding sustainability: A case study in first year engineering, Monash University, Australia

While there is clear recognition of the need to incorporate sustainable development into university curricula, there is limited research that examines how to achieve that integration or evaluates its impacts on student learning. This paper responds to these knowledge gaps through a case study of curriculum renewal that involved embedding sustainability into a first year engineering curriculum. The initiative was guided by a deliberative and dynamic model for curriculum renewal that brought together internal and external stakeholders through a structured sequence of facilitated workshops and meetings. That process identified sustainability-related knowledge and skills relevant for first year engineering, and faculty members teaching in the first year program were guided through a process of curriculum renewal to meet those needs. The process through which the whole of curriculum renewal was undertaken is innovative and provides a case study of precedent in the field of education for sustainability. The study demonstrates the contribution that can be made by a web-based sustainability portal in supporting curriculum renewal. Learning and teaching outcomes were evaluated through ‘before and after surveys’ of the first year engineering students. Statistically significant increases in student's self-reported knowledge of sustainability were measured as a result of exposure to the renewed first year curriculum and this confirmed the value of the initiative in terms of enhancing student learning. While applied in this case to engineering, the process to achieve integration of sustainability into the curriculum approach is likely to have value for other academic disciplines. Considering student performance on assignments and exam questions relating to sustainability would provide a stronger basis for future research to understand the impact of initiatives like this on student learning.

Benefits of blended learning for the first year medical imaging students in preparation for clinical placement

Although there is a plethora of definitions of blended learning, the underlying distinguishing feature is the combination of traditional content delivery and the utilisation of technology. Within Medical Imaging undergraduate education there is evidence of advantages and increased student engagement when utilising a blended learning approach. Although the embedding of technology has been proven to be a useful teaching tool, “Educators should tailor their teaching media to learner’s needs rather than assume that web based learning is intrinsically superior”. This study aims to determine which clinical learning tools are perceived to be the most useful to the student in preparing them for placements.

Understanding consumers' decisions to adopt technology-enabled transformative services

This study extends understanding of consumers' decisions to adopt transformative services delivered via technology. It incorporates competitive effects into the model of goal-directed behavior which, in keeping with the majority of consumer decision making models, neglects to explicitly account for competition. A goal-level operationalization of competition, incorporating both direct and indirect competition, is proposed. A national web-based survey collected data from 431 respondents about their decisions to adopt mental health services delivered via mobile phone. The findings show that the extent to which consumers perceived using these transformative services to be more instrumental to achieving their goals than competition had the greatest impact on their adoption decisions. This finding builds on the limited empirical evidence for the inclusion of competitive effects to more fully explain consumers' decisions to adopt technology-based and other services. It also provides support for a broader operationalization of competition with respect to consumers' personal goals.

Is there a relationship between screening for diabetes related foot complications and limb amputation?

Background From the conservative estimates of registrants with the National Diabetes Supply Scheme, we will be soon passing 1.1 Million Australians affected by all types of diabetes. The diabetes complications of foot ulceration and amputation are costly to all. These costs can be reduced with appropriate prevention strategies, starting with identifying people at risk through primary care diabetic foot screening. Yet levels of diabetic foot screening in Australia are difficult to quantify. This presentation aims to report on foot screening rates as recorded in existing academic literature, national health surveys and national database reports. Methods Literature searches included diabetic foot screening that occurred in the primary care setting for populations over 2000 people from 2002 to 2014. Searches were performed using Medline and CINAHL as well as internet searches of Organisations for Economic Co-operation and Development (OECD) countries health databases. The focus is on type 1 and type 2 diabetes in adults, and not gestational diabetes or children. The two primary outcome measures were foot -screening rates as a percentage of adult diabetic population and major lower limb amputation incidence rates from standardised OECD data. Results The most recent and accurate level for Australian population review was in the AUSDIAB (Australian Diabetes and lifestyle survey) from 2004. This survey reported screening in primary care to be as low as 50%. Countries such as the United Kingdom and United States of America have much higher reported rates of foot screening (67-86%) recorded using national databases and web based initiatives that involve patients and clinicians. By comparison major amputation rates for Australia were similar to the United Kingdom at 6.5 versus 5.1 per 100,000 population, but dis-similar to the United States of America at 17 per 100,000 population. Conclusions Australian rates of diabetic foot screening in primary care centres is ambiguous. There is no direct relationship between foot screening levels in a primary care environment and major lower limb amputation, based on national health survey's and OECD data. Uptake of national registers, incentives and web-based systems improve levels of diabetic foot assessment, which are the first steps to a healthier diabetic population.

Verkkoradio, musiikki ja radio - katsaus verkkoradioihin osana suomalaisten musiikin kuuntelua

This thesis examines Internet-radios and other web-based music services, and different ways these services are used in music listening in Finland. The research material was gathered in eight interviews that took place between spring 2005 and spring 2006 in southern Finland. The analysis distinguishes between five main types of Internet-radios: a) simulcasting, b) webcasting, c) podcasting, d) web-based sound archives, e) interactive music services. As a medium for music listening these combine aspects of computers and traditional radio. The role of Internet-radios in everyday life as well as different types of listening motivation are examined in the light of earlier research on taste, music listening and radio listening.

How to design educational settings to promote collaborative inquiry: Pedagogical infrastructures for technology-enhanced progressive inquiry

Strategies of scientific, question-driven inquiry are stated to be important cultural practices that should be educated in schools and universities. The present study focuses on investigating multiple efforts to implement a model of Progressive Inquiry and related Web-based tools in primary, secondary and university level education, to develop guidelines for educators in promoting students collaborative inquiry practices with technology. The research consists of four studies. In Study I, the aims were to investigate how a human tutor contributed to the university students collaborative inquiry process through virtual forums, and how the influence of the tutoring activities is demonstrated in the students inquiry discourse. Study II examined an effort to implement technology-enhanced progressive inquiry as a distance working project in a middle school context. Study III examined multiple teachers' methods of organizing progressive inquiry projects in primary and secondary classrooms through a generic analysis framework. In Study IV, a design-based research effort consisting of four consecutive university courses, applying progressive inquiry pedagogy, was retrospectively re-analyzed in order to develop the generic design framework. The results indicate that appropriate teacher support for students collaborative inquiry efforts appears to include interplay between spontaneity and structure. Careful consideration should be given to content mastery, critical working strategies or essential knowledge practices that the inquiry approach is intended to promote. In particular, those elements in students activities should be structured and directed, which are central to the aim of Progressive Inquiry, but which the students do not recognize or demonstrate spontaneously, and which are usually not taken into account in existing pedagogical methods or educational conventions. Such elements are, e.g., productive co-construction activities; sustained engagement in improving produced ideas and explanations; critical reflection of the adopted inquiry practices, and sophisticated use of modern technology for knowledge work. Concerning the scaling-up of inquiry pedagogy, it was concluded that one individual teacher can also apply the principles of Progressive Inquiry in his or her own teaching in many innovative ways, even under various institutional constraints. The developed Pedagogical Infrastructure Framework enabled recognizing and examining some central features and their interplay in the designs of examined inquiry units. The framework may help to recognize and critically evaluate the invisible learning-cultural conventions in various educational settings and can mediate discussions about how to overcome or change them.

Roles, responsibilities and scope of practice: describing the ‘state of play’ for infection control professionals in Australia and New Zealand

Background In the past decade the policy and practice context for infection control in Australia and New Zealand has changed, with infection control professionals (ICPs) now involved in the implementation of a large number of national strategies. Little is known about the current ICP workforce and what they do in their day-to-day positions. The aim of this study was to describe the ICP workforce in Australia and New Zealand with a focus on roles, responsibilities, and scope of practice. Methods A cross-sectional design using snowball recruitment was employed. ICPs completed an anonymous web-based survey with questions on demographics; qualifications held; level of experience; workplace characteristics; and roles and responsibilities. Chi-squared tests were used to determine if any factors were associated with how often activities were undertaken. Results A total of 300 ICPs from all Australian states and territories and New Zealand participated. Most ICPs were female (94%); 53% were aged over 50, and 93% were employed in registered nursing roles. Scope of practice was diverse: all ICPs indicated they undertook a large number and variety of activities as part of their roles. Some activities were undertaken on a less frequent basis by sole practitioners and ICPs in small teams. Conclusion This survey provides useful information on the current education, experience levels and scope of practice of ICPs in Australia and New Zealand. Work is now required to establish the best mechanisms to support and potentially streamline scope of practice, so that infection-control practice is optimised.

Widening Perspectives of Teacher Education : Studies on theory-practice relationship, reflection, research and professional development

This dissertation examined the research-based teacher education at the University of Helsinki from different theoretical and practical perspectives. Five studies focused on these perspectives separately as well as overlappingly. Study I focused on the reflection process of graduating teacher students. The data consisted of essays the students wrote as their last assignment before graduating, where their assignment was to examine their development as researchers during their MA thesis research process. The results indicated that the teacher students had analysed their own development thoroughly during the process and that they had reflected on theoretical as well as practical educational matters. The results also pointed out that, in the students’ opinion, personally conducted research is a significant learning process. -- Study II investigated teacher students’ workplace learning and the integration of theory and practice in teacher education. The students’ interviews focused on their learning of teacher’s work prior to education. The interviewees’ responses concerning their ‘surviving’ in teaching prior to teacher education were categorized into three categories: learning through experiences, school as a teacher learning environment, and case-specific learning. The survey part of the study focused on integration of theory and practice within the education process. The results showed that the students who worked while they studied took advantage of the studies and applied them to work. They set more demanding teaching goals and reflected on their work more theoretically. -- Study III examined practical aspects of the teacher students’ MA thesis research as well as the integration of theory and practice in teacher education. The participants were surveyed using a web-based survey which dealt with the participants’ teacher education experiences. According to the results, most of the students had chosen a practical topic for their MA thesis, one arising from their work environment, and most had chosen a research topic that would develop their own teaching. The results showed that the integration of theory and practice had taken place in much of the course work, but most obviously in the practicum periods, and also in the courses concerning the school subjects. The majority felt that the education had in some way been successful with regards to integration. -- Study IV explored the idea of considering teacher students’ MA thesis research as professional development. Twenty-three teachers were interviewed on the subject of their experiences of conducting research about their own work as teachers. The results of the interviews showed that the reasons for choosing the MA thesis research topic were multiple: practical, theoretical, personal, professional reasons, as well as outside effect. The objectives of the MA thesis research, besides graduating, were actual projects, developing the ability to work as teachers, conducting significant research, and sharing knowledge of the topic. The results indicated that an MA thesis can function as a tool for professional development, for example in finding ways for adjusting teaching, increasing interaction skills, gaining knowledge or improving reflection on theory and/or practice, strengthening self-confidence as a teacher, increasing researching skills or academic writing skills, as well as becoming critical and being able to read scientific and academic literature. -- Study V analysed teachers’ views of the impact of practitioner research. According to the results, the interviewees considered the benefits of practitioner research to be many, affecting teachers, pupils, parents, the working community, and the wider society. Most of the teachers indicated that they intended to continue to conduct research in the future. The results also showed that teachers often reflected personally and collectively, and viewed this as important. -- These five studies point out that MA thesis research is and can be a useful tool for increasing reflection doing with personal and professional development, as well as integrating theory and practice. The studies suggest that more advantage could be taken of the MA thesis research project. More integration of working and studying could and should be made possible for teacher students. This could be done in various ways within teacher education, but the MA thesis should be seen as a pedagogical possibility.