Post-discharge surveillance : can patients reliably diagnose surgical wound infections?

Post-discharge surgical wound infection surveillance is an important part of many infection control programs. It is frequently undertaken by patient self-assessment, prompted either by a telephone or postal questionnaire. To assess the reliability of this method, 290 patients were followed for six weeks postoperatively. Their wounds were photographed and also covertly assessed for signs of infection by two experienced infection control nurses (ICNs). Patients also responded to a postal questionnaire seeking evidence of infection at both week four and week six post-surgery. Correlation between the patient's assessment of their wound and the ICNs diagnosis was poor (r=0.37) with a low positive predictive value (28.7%), although negative predictive value was high (98.2%). Assessment of photos for signs of infection by two experienced clinicians also correlated poorly with the ICNs diagnosis of infection (r=0.54). The patient's recall of prescription of an antibiotic by their general practitioner (GP) for wound infection during the postoperative period correlated best with the ICNs diagnosis (r=0.76). This latter measure, particularly when confirmed by the GP in those patients reporting an infection, appears to provide the most valid and resource efficient marker of post-discharge surgical wound infection.

Public, private, or hybrid? What the upstream oil and gas industry can learn from other sectors about ‘the cloud’

Despite the compelling case for moving towards cloud computing, the upstream oil & gas industry faces several technical challenges—most notably, a pronounced emphasis on data security, a reliance on extremely large data sets, and significant legacy investments in information technology (IT) infrastructure—that make a full migration to the public cloud difficult at present. Private and hybrid cloud solutions have consequently emerged within the industry to yield as much benefit from cloud-based technologies as possible while working within these constraints. This paper argues, however, that the move to private and hybrid clouds will very likely prove only to be a temporary stepping stone in the industry’s technological evolution. By presenting evidence from other market sectors that have faced similar challenges in their journey to the cloud, we propose that enabling technologies and conditions will probably fall into place in a way that makes the public cloud a far more attractive option for the upstream oil & gas industry in the years ahead. The paper concludes with a discussion about the implications of this projected shift towards the public cloud, and calls for more of the industry’s services to be offered through cloud-based “apps.”

Can a childcare practicum encourage degree qualified staff to enter the childcare workforce?

Concern to ensure that all children have access to high quality educational experiences in the early years of life has instigated moves to increase qualifications of staff in the childcare workforce, in particular to increase the number of degree qualified teachers. However existing data suggest that work in the childcare sector is viewed less favourably by those undertaking early childhood education degrees. For most, childcare is not a preferred place of employment. This study asked whether a practicum in a childcare setting would improve attitudes to childcare and willingness to consider working in childcare settings. In a study of a cohort of Bachelor of Education (Early Childhood) students, measures of attitudes to childcare and willingness to work in childcare were taken before and after practicum. Additionally students provided accounts of their practicum experiences. Results indicate a trend in which there was a group increase in positive attitudes and willingness to consider work in childcare but considerable individual differences influenced by the quality of the practicum experience. The relationship with, and model provided by, centre directors and the group leader in the practicum class was identified as key influencing factors. Results are discussed in term of models of pedagogical leadership.

How can universities support beginning teachers?

Many beginning teachers struggle in teaching, consequently, tertiary education has been criticised for not preparing preservice teachers well enough. This qualitative study uses interviews and questionnaires to investigate 10 first-year teachers’ understandings of how universities can support them more effectively. The findings indicated that university preparation needed more literacy (particularly reading and spelling), numeracy, catering for lower socio-economic students, understanding behaviour differentiation, and communicating with parents. A two-prong approach may support beginning teachers: (1) timely induction and mentoring within school settings, and (2) research for advancing teacher education coursework to ensure currency of addressing beginning teachers’ needs.

How can schools support beginning teachers? A call for timely induction and mentoring for effective teaching

Induction programs largely focus on informing the beginning teacher about the school culture and infrastructure yet the core business of education is teaching and learning. This qualitative study uses a survey, questionnaire, and interviews to investigate 10 beginning teachers’ needs towards becoming effective teachers in their first year of teaching. Findings were synonymous with studies in other countries that showed they required more support in the induction process, particularly around the school context, networking, managing people, and creating work-life balances. It also found that these beginning teachers required more support in school culture and infrastructure with stronger consideration of developing teaching practices, such as: pedagogical knowledge development and behaviour management. It highlighted willing and capable assigned mentors who can model practices and provide feedback on the beginning teachers’ practices as pivotal to induction and mentoring processes.

Communication predicaments of older health care consumers : what can 'we' do about it?

Focuses on the importance of communication to the well-being of older people in Australia. Role of communication for the design, delivery and evaluation of health services for the elderly; Impact of aging on communication; Importance of communication between health care providers and nursing home residents.

Can we deliver both population-based and personalized approaches to cancer care?

Responding to the individual needs of the person affected by cancer is a fundamental tenet of nursing care. The evidence base to enable highly personalized approaches to the way we provide care has grown enormously in recent years. Today, we have a much better understanding of the mechanisms underpinning health needs of people with cancer, as well as the wide range of environmental, sociocultural, psychological, and biological influences on these needs. This growing evidence base enables us to better target and tailor interventions in increasingly sophisticated ways.

Extreme architecture : can architects future proof us against fire and flood.

In the face of Australia’s disaster-prone environment, architects Ian Weir and James Davidson are reconceptualising how our residential buildings might become more resilient to fire, flood and cyclone. With their first-hand experience of natural disasters, James, director of Emergency Architects Australia (EAA), and Ian, one of Australia’s few ‘bushfire architects’, discuss the ways we can design with disaster in mind. Dr Ian Weir is one of Australia’s few ‘bushfire architects’. Exploring a holistic ‘ground up’ approach to bushfire where landscape, building design and habitation patterns are orchestrated to respond to site-specific fire characteristics. Ian’s research is developed through design studio teaching at QUT and through built works in Western Australia’s fire prone forests and heathlands.

What can grassroots leadership teach us about school leadership

This paper explores grassroots leadership, an under-researched and often side-lined approach to leadership that operates outside of formal bureaucratic structures. The paper’s central purpose is the claim that an understanding of grassroots leadership and tactics used by grassroots leaders provides valuable insights for the study of school leadership. In this paper, we present and discuss an original model of grassroots leadership based on the argument that this under-researched area can further our understanding of school leadership. Drawing upon the limited literature in the field, we present a model consisting of two approaches to change (i.e. conflict and consensus) and two categories of change (i.e. reform and refinement) and then provide illustrations of how the model works in practice. We make the argument that the model has much merit for conceptualizing school leadership, and this is illustrated by applying the model to formal bureaucratic leadership within school contexts. Given the current climate in education where business and management language is pervasive within leadership-preparation programs, we argue that it is timely for university academics, who are responsible for preparing school leaders to consider broadening their approach by exposing school leaders to a variety of change-based strategies and tactics used by grassroots leaders.

STEM futures and practice, can we teach STEM in a more meaningful and integrated way?

Integrating Science, Technology, Engineering and Mathematics (STEM) subjects can be engaging for students, can promote problem-solving and critical thinking skills and can help build real-world connections. However, STEM has long been an area of some confusion for some educators. While they can see many of the conceptual links between the various domains of knowledge they often struggle to meaningfully integrate and simultaneously teach the content and methodologies of each these areas in a unified and effective way for their students. Essentially the question is;how can the content and processes of four disparate and yet integrated learning areas be taught at the same time? How can the integrity of each of the areas be maintained and yet be learnt in a way that is complementary? Often institutional barriers exitin schools and universities to the integration of STEM. Organizationally, at a departmental and administrative level, the teaching staff may be co-located, but when it comes to classroom practice or the teaching and learning of these areas they are usually taught very separately. They are usually taught in different kinds of spaces, in different ways (using different pedagogical approaches) and at different times. But is this the best way for students to engage with the STEM areas of learning? How can we make learning more integrated, meaningful and engaging for the students?

Studios for the masses : can student colaboration replace the master-apprentice relationship in design instruction?

This action research project investigated the use of a collaborative learning approach for addressing issues associated with teaching urban design to large, diverse cohorts. As a case study, I observed two semesters of an urban design unit that I revised between 2011 and 2012 to incorporate collaborative learning activities. Data include instructional materials, participant observations, peer-reviews of collaborative learning activities, feedback from students and instructors and student projects. Themes that emerged through qualitative analysis include the challenge of removing inequalities inherent in the diverse cohort, the challenge of unifying project guidance and marking criteria, and the challenge of providing project guidance for a very large cohort. Most notably, the study revealed a need to clarify learning objectives relating to design principles in order to fully transition to and benefit from a collaborative learning model.

Symposium - How effective are brief motivational interviewing interventions : Are they necessary? Do they require enhancement? Can they be translated into routine clinical practice?

Brief interventions are effective for problem drinking and reductions are known to occur in association with screening and assessment. Design and methods: This study aimed to determine how much change occurred between baseline assessment and a one-session brief intervention (S1), and the predictors of early change among adults with comorbid depression and alcohol misuse (n=202) participating in a clinical trial. The primary focus was on changes in Beck Depression Inventory fastscreen scores and alcohol consumption (standard drinks per week) prior to random allocation to nine further sessions addressing either depression, alcohol, or both problems. Results: There were large and clinically significant reductions between baseline and S1, with the strongest predictors being baseline scores in the relevant domain and change in the other domain. Client engagement was also predictive of early depression changes. Discussion and Conclusion: Monitoring progress in both domains from first contact, and provision of empathic care, followed by brief intervention appear to be useful for this high prevalence comorbidity...

Can a community pharmacy sleep assessment tool aid the identification of patients at risk of sleep disorders in the community : a pilot study

Background: When experiencing sleep problems for the first time, consumers may often approach community pharmacists for advice as they are easily accessible health care professionals in the community. In Australian community pharmacies there are no specific tools available for use by pharmacists to assist with the assessment and handling of consumers with sleep enquiries. Objective: To assess the feasibility of improving the detection of sleep disorders within the community through the pilot of a newly developed Community Pharmacy Sleep Assessment Tool (COP-SAT). Method: The COP-SAT was designed to incorporate elements from a number of existing, standardized, and validated clinical screening measures. The COP-SAT was trialed in four Australian community pharmacies over a 4-week period. Key findings: A total of 241 community pharmacy consumers were assessed using the COP-SAT. A total of 74 (30.7%) were assessed as being at risk of insomnia, 26 (10.7%) were at risk of daytime sleepiness, 19 (7.9%) were at risk of obstructive sleep apnea, and 121 (50.2%) were regular snorers. A total of 116 (48.1%) participants indicated that they consume caffeine before bedtime, of which 55 (47%) had associated symptoms of sleep onset insomnia. Moreover, 85 (35%) consumed alcohol before bedtime, of which 50 (58%) experienced fragmented sleep, 50 (58%) were regular snorers, and nine (10.6%) had apnea symptoms. The COP-SAT was feasible in the community pharmacy setting. The prevalence of sleep disorders in the sampled population was high, but generally consistent with previous studies on the general population. Conclusion: A large proportion of participants reported sleep disorder symptoms, and a link was found between the consumption of alcohol and caffeine substances at bedtime and associated symptoms. While larger studies are needed to assess the clinical properties of the tool, the results of this feasibility study have demonstrated that the COP-SAT may be a practical tool for the identification of patients at risk of developing sleep disorders in the community.

Timing and emplacement dynamics of newly recognised mass flow deposits at ~ 8–12 ka offshore Soufrière Hills volcano, Montserrat : how submarine stratigraphy can complement subaerial eruption histories

This contribution describes two mass movement deposits (total volume ~0.5 km3) identified in seven marine cores located 8 to 15 km offshore southern Montserrat, West Indies. The deposits were emplaced in the last 35 ka and have not previously been recognised in either the subaerial or distal submarine records. Age constraints, provided by radiocarbon dating, show that an explosive volcanic eruption occurred at ca 8–12 ka, emplacing a primary eruption-related deposit that overlies a large (~0.3 km3) reworked bioclastic and volcaniclastic flow deposit, formed from a shelf collapse between 8 and 35 ka. The origin of these deposits has been deduced through the correlation of marine sediment cores, component analysis and geochemical analysis. The 8–12 ka primary volcanic deposit was likely derived from a highly-erosive pyroclastic flow from the Soufrière Hills volcano that entered the ocean and mixed with the water column forming a water-supported density current. Previous investigations of the eruption record suggested that there was a hiatus in activity at the Soufrière Hills volcano between 16 and 6 ka. The ca 8–12 ka eruptive episode identified here shows that this hiatus was shorter than previously hypothesised, and thus highlights the importance of obtaining an accurate and completemarine record of events offshore from volcanic islands and incorporating such data into eruption history reconstructions. Comparisons with the submarine deposit characteristics of the 2003 dome collapse also suggests that the ~8–12 ka eruptive episode was more explosive than eruptions from the current eruptive episode.

Can a “Blue Sky” return to Indian megacities?

Deterioration of air quality in Indian megacities (Delhi, Mumbai or Kolkata) is much more significant than that observed in the megacities of developed countries. Densely packed high-rise buildings restrict the self-cleaning capabilities of Indian megacities. Also, the ever growing number of on-road vehicles, resuspension of the dust, and anthropogenic activities exacerbate the levels of ambient air pollution, which is in turn breathed by urban dwellers. Pollution levels exceeding the standards on a regular basis often result in a notable increase in morbidity and mortality. This article discusses the challenges faced by Indian megacities in their quest for sustainable growth, without compromising the air quality and urban way of life.