SSCRC Austin ICU Handover

Video presented as part of Melbourne Smart Services CRC Participants conferences. Video showing the results of our collaboration with the Smart Services CRC and Austin Health. We created an environment for nurses to learn ICU Handover processes. Handover processes in an ICU involve, briefing meetings with ward nurses, and then a bedside handover of patient care information to the nurse starting the next shift. This simulation will allow students to remotely practice their handover skills, thus freeing up expensive resources at teaching hospitals, and enabling them to be at a higher skill level when they commence live training. More information available at: www.bpmve.org.

Unravelling the maze : Hepatitis C, psychosocial factors and access to antiviral therapy

In this paper we present an examination of the literature on the psychosocial aspects of hepatitis C (HCV), and ask what are the implications for patients and clinicians regarding access to treatment? Hepatitis C (HCV) is a blood-borne communicable disease that was identified in 1988. In Australia, an estimated 217,000 people live with HCV. The virus causes serious liver inflammation, can lead to liver cirrhosis and a small percentage of sufferers will develop hepatocellular carcinoma. Reports about the psychosocial aspects of HCV appeared from around 1994 indicating a similar set of societal responses to people with HIV; stigmatisation and discrimination. A number of calls were made for the establishment of counselling and support services to address the specific mental health needs of people with HCV. We conducted a systematic review of the literature between 2002-2012 about the psychosocial aspects of HCV and its relationship to access to treatment and identified a number of key issues that suggest the anticipated progress in this area has not been made. The majority of people with HCV already experience marginalisation, and the diagnosis of HCV further compounds their marginalisation through stigma and discrimination and complicates clinical decision-making around treatment. We conclude that the need for mental health services that are capable of addressing the complexities of the psychosocial aspects of HCV remains. Concomitantly, primary care clinicians require greater clarity and consistency about the clinical guidelines for HCV to meet the increasing expectations on them to deliver comprehensive patient management within primary care. (248 words)

Aliens, borders and social citizens : Health and community services for trafficked women

Australian policy makers recognise women who are trafficked to Australia (and these are largely for the purposes of sexual exploitation) primarily as victims of crime. The main public mechanism by which the "problem" of trafficked people in Australia is managed is the criminal law. At the same time, however, as a signatory to the UN Protocol on Trafficking and the Declaration of Human Rights, the Australian Government also recognises the rights of women trafficked to Australia to access health and community services in the wake of the health damage and trauma they often incur as a consequence of their experience. Current evidence suggests that trafficked women in Australia face considerable barriers in being able to avail themselves of such a right and of the services that accompany it. This paper explores the tensions posed by Australian policy and service approaches to trafficked women in light of the concept of social citizenship and the ways in which it is mediated in the Australian context by national border protection policy.

College, shared house, or home? The impact of living situation on university students’ drinking

University students are recognised as a heavy drinking group who are at risk of both short and long term harms from their alcohol consumption. This paper explores the social dynamics of drinking and the key differences between three core groups of university students – those who live at home, those living in college and those who live independently. We draw on a large scale survey of Australian university students on alcohol consumption and harm minimisation and extensive qualitative individual and focus group interviews with university students in Victoria, New South Wales and Queensland. Our data suggests that living at home supports safer drinking in comparison to the less regulated college context or living independently in shared households.

SSCRC Project - work in progress

Video presented as part of Smart Services CRC Participants conferences. This video shows an example of the latest version of our middleware linking the YAWL workflow engine to Open Simulator. We have created a simple example of an accident victim being brought into a Hospital to be processed. The preliminary interface to the YAWL accident treatment workflow is shown as a worklist on the left of the image. The tasks are presented to the avatar via this interface, in a similar manner as done in web based workflow systems. Objects in the simulator are instrumented with a knowledge base, that enables the validation of actions within the world, to make sure that tasks are carried out correctly.

Clik goes to Hollywood

Video presented as part of Smart Services CRC Participants conferences. This video is a demonstration of a 3D visualisation of a running workflow in YAWL connected by a custom service to Second Life. The avatar, Clik, is being controlled by a workflow tool called YAWL, as it traverses the workflow schema, illustrating the process of film preproduction and shooting. This video was captured while the workflow tool was running - NO human is controlling the avatar during the video. It is all scripted from an external source on the Internet. See www.bpmve.org for more on this work.

Climate change and reduction of emissions of greenhouse gases from ships : an appraisal

Article 2(2) of the Kyoto Protocol imposes an obligation only on certain developed countries, working through the International Maritime Organisation (IMO), to pursue the reduction of greenhouse gas (GHG) emissions from marine bunker fuels. The IMO recently took the initiative to adopt a new legal instrument for the reduction of shipgenerated greenhouse gas emissions. Some developing countries have suggested that the proposed IMO initiative should strictly adhere to Article 2(2) of the Kyoto Protocol and the principle of Common but Differentiated Responsibility (CBDR). Against this backdrop, this article intends to review the extent to which it is possible to propose an international legal instrument for the reduction of GHG emissions from marine bunker fuels which is applicable only to ships from developed countries considering the complex characteristics of the international shipping industry. This article also examines how far this approach is justifiable even within the framework of the CBDR principle.

The great divide : bridging the gap

Learning Objective: To describe a collaborative system of clinical allocations using a dedicated, discipline specific administrative coordinator. Methods: The Clinical Placement Coordinator is the liaison person between the student, the academic staff and the clinical sites, and fills an important role in bridging the gap to enhance the student learning experience. With this in mind the Coordinator is very discipline focused and works closely with the academic staff who coordinate the clinical units within the program. This person is the ‘‘face’’ of QUT to the external stakeholders, and ensures that all parties experience a smooth process. This no mean feat given that there are over 350 students to be placed annually, across 14 separate clinical blocks ranging from 1 to 6 weeks in length at various sites. The processes involved in clinical placement allocation will be presented, and the roles of the staff in facilitating students’ placement preferences and matching with clinical site offers will be described. In many allied health programs in Australia, the clinical placement activity is carried out by an academic member of staff. However, this can result in delays in communications due to other workload requirements such as lecture, tutorial and practical class commitments. Having a dedicated knowledgeable administration officer has resulted in a person being available to take calls from clinical staff, meet with students to discuss allocation needs and ensure that academic staff are consulted if and when necessary. The Clinical Placement Coordinator is very much a part of the course team and attends professional meetings and conferences as an avenue of networking and meeting clinical staff. Results: The success in having a dedicated administrative officer as the Clinical Placement Coordinator acting as the conduit between academic staff and students, and the university and clinical staff has been highly successful to date. This was noted in commendations from the 2010 Course Accreditation Panel Report which stated: ‘‘The very positive perception in the professional community of Ms Margaret McBurney’s effective and efficient organization of student clinical placements. Students and clinical professionals commented favourably on the approachability of staff. There is confidence that program staff will follow up on issues raised urgently in clinical centres.’’

Paris 1947 : The woman of fashion

Paris 1947 is the site of one of twentieth century fashion’s fictive highpoints. The New Look combined drama and poetics through an abiding rhetoric of elegance. In doing so it employed traditional modes of femininity, casting the woman of fashion in the guise of an ambiguous ‘new’ figure: half fairytale princess, half evil witch. This fashionable ideal was widely disseminated through key photographic representations, Willy Maywald’s 1947 image of the Bar Suit being a case in point. It was precisely such mythic formulations of ‘woman’ which Simone de Beauvoir was to take to task just two years later with the publication of The Second Sex. Driven by frustration with the status quo of real women, de Beauvoir recognised the role of fictive representations, both textual and visual in defining women. This paper reads key sections of The Second Sex through a comparative analysis of two iconic images of French women from 1947; Cartier-Bresson’s classic portrait of de Beauvoir and Willy Mayhold’s spectacular evocation of Christian Dior’s New Look. Cued by a compelling range of similarities between these images this paper explores links between fashion, feminism and fiction in mid-century French culture.

Using a Bayesian network to model colonisation with Vancomycin Resistant Enterococcus (VRE)

Objective: Effective management of multi-resistant organisms is an important issue for hospitals both in Australia and overseas. This study investigates the utility of using Bayesian Network (BN) analysis to examine relationships between risk factors and colonization with Vancomycin Resistant Enterococcus (VRE). Design: Bayesian Network Analysis was performed using infection control data collected over a period of 36 months (2008-2010). Setting: Princess Alexandra Hospital (PAH), Brisbane. Outcome of interest: Number of new VRE Isolates Methods: A BN is a probabilistic graphical model that represents a set of random variables and their conditional dependencies via a directed acyclic graph (DAG). BN enables multiple interacting agents to be studied simultaneously. The initial BN model was constructed based on the infectious disease physician‟s expert knowledge and current literature. Continuous variables were dichotomised by using third quartile values of year 2008 data. BN was used to examine the probabilistic relationships between VRE isolates and risk factors; and to establish which factors were associated with an increased probability of a high number of VRE isolates. Software: Netica (version 4.16). Results: Preliminary analysis revealed that VRE transmission and VRE prevalence were the most influential factors in predicting a high number of VRE isolates. Interestingly, several factors (hand hygiene and cleaning) known through literature to be associated with VRE prevalence, did not appear to be as influential as expected in this BN model. Conclusions: This preliminary work has shown that Bayesian Network Analysis is a useful tool in examining clinical infection prevention issues, where there is often a web of factors that influence outcomes. This BN model can be restructured easily enabling various combinations of agents to be studied.

Workplace information literacy : cultivation strategies for 'working smarter' in 21st century libraries

This paper presents a hybrid framework of Swedish cultural practices and Australian grounded theory for organizational development and suggests practical strategies for 'working smarter' in 21st Century libraries. Toward that end, reflective evidence-based practices are offered to incrementally build organizational capacity for asking good questions, selecting authoritative sources, evaluating multiple perspectives, organizing emerging insights, and communicating them to inform, educate, and influence. In addition, to ensure the robust information exchange necessary to collective workplace learning, leadership traits are proposed for ensuring inclusive communication, decision making, and planning processes. These findings emerge from action research projects conducted from 2003 to 2008 in two North American libraries.

Life in the baby boomer library world : a survival guide

According to Australian Job Search, just 14% of librarians are under the age of 35. As a Generation Y librarian, flexibility is a key factor to ensuring survival in the Baby Boomer library and overcoming employment, promotion and in particular stereotype barriers. This paper draws upon generational and library workforce research, coupled with industry experience to provide practical advice and strategies to break through both personal and professional barriers for the Generation Y librarian in the Baby Boomer library world. Industry understanding, drawn from personal experiences of working in public, education and special libraries, utilises my journey as a librarian since graduation in 2005 to discuss barriers faced and methods for breaking through. In my previous position as Teaching and Learning Librarian at Northern Melbourne Institute of TAFE from 35 library staff I was the sole member under 30. In addition I was the youngest member of the Library Management Team by 20 years, providing a perfect example of the Generation Y librarian within a Baby Boomer environment. This experience provides the platform for exploring strategies for understanding and overcoming ageist ideas, generational stereotypes, and employment barriers. Discussion regarding the need to develop sound industry knowledge for survival within the library world will also be raised.

The role of perceived usefulness and attitude on electronic health record acceptance : an empirical investigation using response surface analysis

Information and communications technologies are a significant component of the healthcare domain and electronic health records play a major role within it. As a result, it is important that they are accepted en masse by healthcare professionals. How healthcare professionals perceive the usefulness of electronic health records and their attitudes towards them have been shown to have significant effects on their overall acceptance. This paper investigates the role of perceived usefulness and attitude on the intention to use electronic health records by future healthcare professionals using polynomial regression with response surface analysis. Results show that the relationship is more complex than predicted in prior research. The paper concludes that the predicting properties of the above determinants must be further investigated to clearly understand their role in predicting the intention to use electronic health records and in designing systems that are better adopted by healthcare professionals of the future.

Health complaints commissions in Australia : Time for a national approach to data collection

Health complaint commissions in Australia: Time for a national approach • There is considerable variation between jurisdictions in the ways complaint data are defined, collected and recorded by the Health complaint commissions. • Complaints from the public are an important accountability mechanism and an indicator of service quality. • The lack of a consistent approach leads to fragmentation of complaint data and a lost opportunity to use national data to assist policy development and identify the main areas causing consumers to complain. • We need a national approach to complaints data collection by the Health complaints commissions in order to better respond to patients’ concerns

Patient Safety Law: From Silos to Systems

Patient safety has become a significant and pressing policy issue. Around the world, governments, the health care sector and the public are increasingly cognizant of the need to improve the safety of care delivered by their health systems. Pressure for change has been created by highly publicized incidents in a number of countries involving unsafe acts that were significant both in scale and consequence and a number of empirical studies that revealed the high rates of unsafe acts and their consequences. The costs of unsafe health care – both personal and fiscal – to individuals, their families and their communities and to the state are massive. In this research project we explored one particular avenue for change – that is, the use of legal instruments by governments to improve patient safety. We did this through a comparative review of the use of legal instruments or frameworks in other countries (specifically Australia, Denmark, New Zealand, the United Kingdom, and the United States) as well as two non-health care related sectors in Canada (transportation and occupational health and safety). We began this research by reviewing the legal instruments and undertaking extensive literature reviews. Further information was gathered through in-person interviews with policy-makers and academics in the countries studied, and from policy-makers and academics expert in the health, occupational health and safety, and transportation sectors in Canada. Once descriptions of the various countries and sectors were drafted, we held small-group meetings with local experts on particular aspects of patient safety. We then hosted a national consultation meeting. We subsequently drafted this final report and the appendices, which fully describe the results of the background research. Finally, we prepared a summary version of the report as well as posters and papers to be published and delivered at conferences and meetings with relevant groups.