Information support for health management in regional Sri Lanka : health managers’ perspectives

Good management, supported by accurate, timely and reliable health information, is vital for increasing the effectiveness of Health Information Systems (HIS). When it comes to managing the under resourced health systems of developing countries, information-based decision making is particularly important. This paper reports findings of a self-report survey that investigated perceptions of local health managers (HMs) of their own regional HIS in Sri Lanka. Data were collected through a validated, pre-tested postal questionnaire, and distributed among a selected group of HMs to elicit their perceptions of the current HIS in relation to information generation, acquisition and use, required reforms to the information system and application of information and communication technology (ICT). Results based on descriptive statistics indicated that the regional HIS was poorly organised and in need of reform; that management support for the system was unsatisfactory in terms of relevance, accuracy, timeliness and accessibility; that political pressure and community and donor requests took precedence over vital health information when management decisions were made; and use of ICT was unsatisfactory. HIS strengths included user-friendly paper formats, a centralised planning system and an efficient disease notification system; weaknesses were lack of comprehensiveness, inaccuracy, and lack of a feedback system. Responses of participants indicated that HIS would be improved by adopting an internationally accepted framework and introducing ICT applications. Perceived barriers to such improvements were high initial cost of educating staff to improve computer literacy, introduction of ICTs, and HIS restructure. We concluded that the regional HIS of Central Province, Sri Lanka had failed to provide much needed information support to HMs. These findings are consistent with similar research in other developing countries and reinforce the need for further research to verify causes of poor performance and to design strategic reforms to improve HIS in regional Sri Lanka.

Student or scholar? Transforming identities through a research writing group

This article explores the role a writing group played in influencing the scholarly identities of a group of doctoral students by fostering their writing expertise. While the interest in writing groups usually centres on their potential to support doctoral students to publish, few studies have been conducted and written by the students themselves. Using a situated learning perspective on identity, we explore the connection that emerged between our perceptions of ourselves as developing expertise as scholarly writers and the function of the writing group as a dynamic space for transforming our identities. Findings show that our writing group served as a flexible and interactive Community of Practice (CoP) that shaped critical and durable shifts in identity amongst members.

A history of heart interventions moderates the relationship between psychological variables and the presence of chest pain in older women with self-reported coronary heart disease

Objectives: This study examines the hypothesis that a past history of heart interventions will moderate the relationship between psychosocial factors (stressful life events, social support, perceived stress, having a current partner, having a past diagnosis of depression or anxiety over the past 3 years, time pressure, education level, and the mental health index) and the presence of chest pain in a sample of older women. Design: Longitudinal survey over a 3-year period. Methods: The sample was taken from a prospective cohort study of 10,432 women initially aged between 70 and 75 years, who were surveyed in 1996 and then again in 1999. Two groups of women were identified: those reporting to have heart disease but no past history of heart interventions (i.e., coronary artery bypass graft/angioplasty) and those reporting to have heart disease with a past history of heart interventions. Results: Binary logistic regression analysis was used to show that for the women with self-reported coronary heart disease but without a past history of heart intervention, feelings of time pressure as well as the number of stressful life events experienced in the 12 months prior to 1996 were independent risk factors for the presence of chest pain, even after accounting for a range of traditional risk factors. In comparison, for the women with self-reported coronary heart disease who did report a past history of heart interventions, a diagnosis of depression in the previous 3 years was the significant independent risk factor for chest pain even after accounting for traditional risk factors. Conclusion: The results indicate that it is important to consider a history of heart interventions as a moderator of the associations between psychosocial variables and the frequency of chest pain in older women. Statement of Contribution: What is already known on this subject? Psychological factors have been shown to be independent predictors of a range of health outcomes in individuals with coronary heart disease, including the presence of chest pain. Most research has been conducted with men or with small samples of women; however, the evidence does suggest that these relationships exist in women as well as in men. What does this study add? Most studies have looked at overall relationships between psychological variables and health outcomes. The few studies that have looked at moderators have mainly examined gender as a moderator. To our knowledge, this is the first published study to examine a history of heart interventions as a moderator of the relationship between psychological variables and the presence of chest pain.

Internet interventions for treatment of alcohol related problems

This is the protocol for a review and there is no abstract. The objectives are as follows: The primary objective of this review will be to assess the effect of internet and mobile phone alcohol-related interventions on reducing participants' alcohol consumption. Secondary objectives will include assessing the impact of the interventions on symptoms of alcohol-related disorders and degree of alcohol dependence, the effects on functioning, and patient acceptability. The review will also assess whether there are different outcomes for different diagnostic groups, and which intervention approaches or components (including therapeutic support) may be contributing to any positive effects.

Creating fashion professionals for the 21st century : a tale of pedagogical tensions and emerging challenges

The ‘Fashion Tales’ Conference identifies three fashion discourses: that of making, that of media, and that of scholarship. We propose a fourth, which provides a foundational base for the others: the discourse of fashion pedagogy. We begin with the argument that to thrive in any of these discourses, all fashion graduates require the ability to navigate the complexities of the 21st century fashion industry. Fashion graduates emerge into a professional world which demands a range of high level capabilities above and beyond those traditionally acknowledged by the discipline. Professional education in fashion must transform itself to accommodate these imperatives. In this paper, we document a tale of fashion learning, teaching and scholarship – the tale of a highly successful future-orientated boutique university-based undergraduate fashion course in Queensland, Australia. The Discipline consistently maintains the highest student satisfaction and lowest attrition of any course in the university, achieves extremely competitive student satisfaction scores when compared with other courses nationally and internationally, and reports outstanding graduate employment outcomes. The core of the article addresses how the course effectively balances five key pedagogical tensions identified from the findings of in-depth focus groups with graduating students, and interviews with teaching staff. The pedagogical tensions are: high concept/ authenticity; high disciplinarity/ interdisciplinarity; high rigour/ play; high autonomy/ scaffolding; and high individuality/ community, where community can be further divided into high challenge and high support. We discuss each of these tensions and how they are characterised within the course, using rich descriptions given by the students. We also draw upon the wider andragogical and learning futures literatures to link the tensions with what is already known about excellence in 21st century higher and further education curriculum and pedagogic practice. We ask: as the fashion industry becomes truly globalised, virtualised, and diversified, and as initial professional training for the industry becomes increasingly massified and performatised, what are the best teaching approaches to produce autonomous, professionally capable, enterprising and responsible graduates into the future? Can the pedagogical balances described in this case study be maintained in the light of these powerful external forces, and if so, how?

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.

Does residential dissonance impact residential mobility?

This research identifies residential mobility behaviour impacts of residential dissonance in Transit Oriented Developments (TODs) vs. non-TODs in Brisbane, Australia. Based on the characteristics of living environments (density, diversity, connectivity, and accessibility) and the travel preferences of 4545 individuals, respondents in 2009 were classified into one of four categories including: TOD consonants, TOD dissonants, non-TOD dissonants, and non-TOD consonants. Binary logistic regression analyses were employed to identify residential mobility behaviour of groups between 2009 and 2011; controlling for time varying covariates. The findings show that both TOD dissonants and TOD consonants move residences at an equal rate. However, TOD dissonants are more likely to move residences to their preferred non-TOD areas. In contrast, non-TOD dissonants not only moved residences at a lower rate, but their rate of mobility to their preferred TOD neighbourhood is also significantly lower due to costs and other associated factors. The findings suggest that discrete land use policy development is required to integrate non-TOD dissonant and TOD dissonant behaviours to support TOD development in Brisbane.

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.

Utility of the Mild Brain Injury Atypical Symptoms Scale to detect symptom exaggeration : an analogue simulation study

Brief self-report symptom checklists are often used to screen for postconcussional disorder (PCD) and posttraumatic stress disorder (PTSD) and are highly susceptible to symptom exaggeration. This study examined the utility of the five-item Mild Brain Injury Atypical Symptoms Scale (mBIAS) designed for use with the Neurobehavioral Symptom Inventory (NSI) and the PTSD Checklist–Civilian (PCL–C). Participants were 85 Australian undergraduate students who completed a battery of self-report measures under one of three experimental conditions: control (i.e., honest responding, n = 24), feign PCD (n = 29), and feign PTSD (n = 32). Measures were the mBIAS, NSI, PCL–C, Minnesota Multiphasic Personality Inventory–2, Restructured Form (MMPI–2–RF), and the Structured Inventory of Malingered Symptomatology (SIMS). Participants instructed to feign PTSD and PCD had significantly higher scores on the mBIAS, NSI, PCL–C, and MMPI–2–RF than did controls. Few differences were found between the feign PCD and feign PTSD groups, with the exception of scores on the NSI (feign PCD > feign PTSD) and PCL–C (feign PTSD > feign PCD). Optimal cutoff scores on the mBIAS of ≥8 and ≥6 were found to reflect “probable exaggeration” (sensitivity = .34; specificity = 1.0; positive predictive power, PPP = 1.0; negative predictive power, NPP = .74) and “possible exaggeration” (sensitivity = .72; specificity = .88; PPP = .76; NPP = .85), respectively. Findings provide preliminary support for the use of the mBIAS as a tool to detect symptom exaggeration when administering the NSI and PCL–C.

Essential elements for recruitment and retention : Generation Y

Purpose: Generation Y (Gen Y) is the newest and largest generation entering the workforce. Gen Y may differ from previous generations in work-related characteristics which may have recruitment and retention repercussions. Currently, limited theoretically-based research exists regarding Gen Y’s work expectations and goals in relation to undergraduate students and graduates. Design/methodology/approach: This study conducted a theoretically-based investigation of the work expectations and goals of student- and working-Gen Y individuals based within a framework incorporating both expectancy-value and goal setting theories. N = 398 provided useable data via an on-line survey. Findings: Overall, some support was found for predictions with career goals loading on a separate component to daily work expectations and significant differences between student- and working- Gen Y on career goals. No significant differences were found, however, between the two groups in daily work expectations. Research limitations/implications: Future research may benefit from adopting a theoretical framework which assesses both daily work expectations and career goals when examining the factors which motivate Gen Y’s decisions to join and remain at a particular organisation. Practical implications: At a practical level, based on the findings, some examples are provided of the means by which organisations may draw upon daily work expectations and career goals of importance to Gen Y and, in doing so, influence the likelihood that a Gen Y individual will join and remain at their particular organisation. Originality/value: This research has demonstrated the utility of adopting a sound theoretical framework in furthering understanding about the motivations which influence organisations’ ability to recruit and retain Gen Y, among both student Gen Y as well as those Gen Y individuals who are already working.

A known-groups evaluation of the Response Bias Scale in a neuropsychological setting

We evaluated the Minnesota Multiphasic Personality Inventory-Second Edition (MMPI-2) Response Bias Scale (RBS). Archival data from 83 individuals who were referred for neuropsychological assessment with no formal diagnosis (n = 10), following a known or suspected traumatic brain injury (n = 36), with a psychiatric diagnosis (n = 20), or with a history of both trauma and a psychiatric condition (n = 17) were retrieved. The criteria for malingered neurocognitive dysfunction (MNCD) were applied, and two groups of participants were formed: poor effort (n = 15) and genuine responders (n = 68). Consistent with previous studies, the difference in scores between groups was greatest for the RBS (d = 2.44), followed by two established MMPI-2 validity scales, F (d = 0.25) and K (d = 0.23), and strong significant correlations were found between RBS and F (rs = .48) and RBS and K (r = −.41). When MNCD group membership was predicted using logistic regression, the RBS failed to add incrementally to F. In a separate regression to predict group membership, K added significantly to the RBS. Receiver-operating curve analysis revealed a nonsignificant area under the curve statistic, and at the ideal cutoff in this sample of >12, specificity was moderate (.79), sensitivity was low (.47), and positive and negative predictive power values at a 13% base rate were .25 and .91, respectively. Although the results of this study require replication because of a number of limitations, this study has made an important first attempt to report RBS classification accuracy statistics for predicting poor effort at a range of base rates.

Indian students at QUT : expectations and experiences

India currently ranks among the top source countries for the Australian education industry and therefore, a better understanding of the concerns and challenges confronted by Indian students is essential. This study was undertaken to assess the needs and expectations of Indian students enrolled at Queensland University of Technology (QUT) that would inform the formulation of strategies to provide superior service to the current and future cohorts of students coming from India. Data collection was undertaken through surveys and focus group meetings. The findings reveal the acute need for more effective dissemination of information prior to the students commencing their programs on both academic and non-academic aspects of university life as well as the resources and support available at QUT. Usage of English in an academic setting, career related services, accommodation, and networking opportunities were identified as some of the key areas of concern by the participants.

Changing learning to improve practice : hand hygiene education in Queensland medical schools

The aim of Queensland Health’s ‘Clean hands are life savers’ program is to change the culture and behaviour of healthcare workers related to hand hygiene. Hand hygiene is considered to be the most effective means of preventing pathogen cross-transmission and healthcare-associated infections. Most hospitals throughout Queensland as well as Australia now manage a hand hygiene program to increase the hand hygiene compliance of all healthcare workers. Reports taken from routine hand hygiene observations reveal that doctors are usually less compliant in their hand-washing practices than other healthcare worker groups. The Centre for Healthcare Related Infection Surveillance and Prevention (CHRISP) has attempted to have an impact on this challenging group through their Medical Leadership Initiative. With education as a core component of the program, efforts were made to ensure our future doctors were receiving information that aligned with Queensland Health standards during their formative years at medical school. CHRISP met with university instructors to understand what infection prevention education was currently included in the curriculum and support the introduction of new learning activities that specifically focused on hand hygiene. This prompted change to the existing curriculum and a range of interventions were employed with mixed success. Although met with challenges, methods to integrate more infection prevention teaching were found.

Shut up & write!

This case-study exemplifies a ‘writing movement’, which is currently occurring in various parts of Australia through the support of social media. A concept emerging from the café scene in San Francisco, ‘Shut Up and Write!’ is a meetup group that brings writers together at a specific time and place to write side by side, thus making writing practice, social. This concept has been applied to the academic environment and our case-study explores the positive outcomes in two locations: RMIT University and QUT. We believe that this informal learning practice can be implemented to assist research students in developing academic skills. DESCRIPTION: Please describe your practice as a case study, including its context; challenge addressed; its aims; what it is; and how it supports creative practice PhD students or supervisors. Additional information may include: the outcomes; key factors or principles that contribute to its effectiveness; anticipated impact/evidence of impact. Research students spend the majority of their time outside of formal learning environments. Doctoral candidates enter their degree with a range of experience, knowledge and needs, making it difficult to provide writing assistance in a structured manner. Using a less structured approach to provide writing assistance has been trialled with promising results (Boud, Cohen, & Sampson, 2001; Stracke, 2010; Devenish et al, 2009). Although, semi structured approaches have been developed and examined, informal learning opportunities have received minimal attention. The primary difference of Shut Up and Write! to other writing practices, is that individuals do not engage in any structured activity and they do not share the outcomes of the writing. The purpose of Shut Up and Write! is to transform writing practice from a solitary experience, to a social one. Shut Up and Write! typically takes place outside of formal learning environments, in public spaces such as a café. The structure of Shut Up and Write! sessions is simple: participants meet at a specific time and place, chat for a few minutes, then they Shut Up and Write for a predetermined amount of time. Critical to the success of the sessions, is that there is no critiquing of the writing, and there is no competition or formal exercises. Our case-study examines the experience of two meetup groups at RMIT University and QUT through narrative accounts from participants. These accounts reveal that participants have learned: • Writing/productivity techniques; • Social/cloud software; • Aspects of the PhD; and • ‘Mundane’ dimensions of academic practice. In addition to this, activities such as Shut Up and Write! promote peer to peer bonding, knowledge exchange, and informal learning within the higher degree research experience. This case-study extends the initial work presented by the authors in collaboration with Dr. Inger Mewburn at QPR2012 – Quality in Postgraduate Research Conference, 2012.

Perceived social support and community adaptation in schizophrenia

Prompted by the continuing transition to community care, mental health nurses are considering the role of social support in community adaptation. This article demonstrates the importance of distinguishing between kinds of social support and presents findings from the first round data of a longitudinal study of community adaptation in 156 people with schizophrenia conducted in Brisbane, Australia. All clients were interviewed using the relevant subscales of the Diagnostic Interview Schedule to confirm a primary diagnosis of schizophrenia. The study set out to investigate the relationship between community adaptation and social support. Community adaptation was measured with the Brief Psychiatric Rating Scale (BPRS), the Life Skills Profile (LSP) and measures of dissatisfaction with life and problems in daily living developed by the authors. Social support was measured with the Arizona Social Support Interview Schedule (ASSIS). The BPRS and ASSIS were incorporated into a client interview conducted by trained interviewers. The LSP was completed on each client by an informal carer (parent, relative or friend) or a professional carer (case manager or other health professional) nominated by the client. Hierarchical regression analysis was used to examine the relationship between community adaptation and four sets of social support variables. Given the order in which variables were entered in regression equations, a set of perceived social support variables was found to account for the largest unique variance of four measures of community adaptation in 96 people with schizophrenia for whom complete data are available from the first round of the three-wave longitudinal study. A set of the subjective experiences of the clients accounted for the largest unique variance in measures of symptomatology, life skills, dissatisfaction with life, and problems in daily living. Sets of community support, household support and functional variables accounted for less variance. Implications for mental health nursing practice are considered.