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.

Use of focus group technique to investigate infection control practice

Use of focus groups as a technique of inquiry is gaining attention in the area of health-care research. This paper will report on the technique of focus group interviewing to investigate the role of the infection control practitioner. Infection control is examined as a specialty area of health-care practice that has received little research attention to date. Additionally, it is an area of practice that is expanding in response to social, economic and microbiological forces. The focus group technique in this study helped a group of infection control practitioners from urban, regional and rural areas throughout Queensland identify and categorise their daily work activities. The outcomes of this process were then analysed to identify the growth in breadth and complexity of the role of the infection control practitioner in the contemporary health-care environment. Findings indicate that the role of the infection control practitioner in Australia has undergone changes consistent with and reflecting changing models of health-care delivery.

Building intercultural competence one “Patch” at a time

This paper describes a program called Patches that was implemented to assist a group of Australian and Malaysian pre-service teachers to enhance their intercultural competence through their involvement in a series of reciprocal learning activities. Each learning experience was considered a “patch” that eventually created a “quilt of intercultural learning.” The purpose of this study was to enhance the intercultural competence of domestic and international students through organized intercultural activities, through a series of reflective writing sessions, and mutual engagement on a common project. The effectiveness of the Patches program was analysed in accordance with Deardorff’s elements of intercultural competence. The qualitative findings indicate that both cohorts of preservice teachers showed elements of intercultural competence through participation in the program, with both groups reporting a deeper appreciation and understanding of how to communicate more effectively in intercultural contexts.

Development and interrater reliability testing of a telephone interview training programme for Australian nurse interviewers

Summary Background The final phase of a three phase study analysing the implementation and impact of the nurse practitioner role in Australia (the Australian Nurse Practitioner Project or AUSPRAC) was undertaken in 2009, requiring nurse telephone interviewers to gather information about health outcomes directly from patients and their treating nurse practitioners. A team of several registered nurses was recruited and trained as telephone interviewers. The aim of this paper is to report on development and evaluation of the training process for telephone interviewers. Methods The training process involved planning the content and methods to be used in the training session; delivering the session; testing skills and understanding of interviewers post-training; collecting and analysing data to determine the degree to which the training process was successful in meeting objectives and post-training follow-up. All aspects of the training process were informed by established educational principles. Results Interrater reliability between interviewers was high for well-validated sections of the survey instrument resulting in 100% agreement between interviewers. Other sections with unvalidated questions showed lower agreement (between 75% and 90%). Overall the agreement between interviewers was 92%. Each interviewer was also measured against a specifically developed master script or gold standard and for this each interviewer achieved a percentage of correct answers of 94.7% or better. This equated to a Kappa value of 0.92 or better. Conclusion The telephone interviewer training process was very effective and achieved high interrater reliability. We argue that the high reliability was due to the use of well validated instruments and the carefully planned programme based on established educational principles. There is limited published literature on how to successfully operationalise educational principles and tailor them for specific research studies; this report addresses this knowledge gap.

Sale of Businesses in Australia (2nd ed.)

The greater volume of businesses sold in Australia each year are small to medium enterprises. The administration of business contracts presents far different challenges than, for example, contracts for the sale of goods alone or contracts for the sale of land. The subject matter comprises both real and personal, and tangible and intangible property. Other considerations that do not affect those other commonplace contracts include dealing with employees who are both remaining and departing, taking account of restraints of trade, and the phenomena of the passing of property being different in respect of different forms of property being transferred in the same contract. In keeping with the format of the previous edition, the book is written with the busy practitioner in mind. It deals with the formation of business contracts, all aspects of disclosure both contractual and statutory, the role of agents, and detailed consideration of the different types of subject matter of small business contracts including, the lease of the premises, intellectual property, goodwill, licences, book debts and plant and equipment. It has up to date treatment of income tax implications of the sale and the impact of the latest Commonwealth legislation on dealing with employees of a business on sale. Consistent with the last edition, the book has chapters on time of the essence and completion, personal securities, restraint of trade clauses, special conditions and remedies for breach by both parties and misleading or deceptive conduct by the seller. In relation to personal securities, whilst the current State and Territory based law on Bills of Sale and other Chattel Securities has been the subject of commentary, the proposed national reform agenda has also been commented upon although that legislation is not due until May 2010 at the earliest

Ask : a health advocacy program for adolescents with an intellectual disability : a cluster randomised controlled trial

Background Adolescents with intellectual disability often have poor health and healthcare. This is partly as a consequence of poor communication and recall difficulties, and the possible loss of specialised paediatric services. Methods/Design A cluster randomised trial was conducted with adolescents with intellectual disability to investigate a health intervention package to enhance interactions among adolescents with intellectual disability, their parents/carers, and general practitioners (GPs). The trial took place in Queensland, Australia, between February 2007 and September 2010. The intervention package was designed to improve communication with health professionals and families’ organisation of health information, and to increase clinical activities beneficial to improved health outcomes. It consisted of the Comprehensive Health Assessment Program (CHAP), a one-off health check, and the Ask Health Diary, designed for on-going use. Participants were drawn from Special Education Schools and Special Education Units. The education component of the intervention was delivered as part of the school curriculum. Educators were surveyed at baseline and followed-up four months later. Carers were surveyed at baseline and after 26 months. Evidence of health promotion, disease prevention and case-finding activities were extracted from GPs clinical records. Qualitative interviews of educators occurred after completion of the educational component of the intervention and with adolescents and carers after the CHAP. Discussion Adolescents with intellectual disability have difficulty obtaining many health services and often find it difficult to become empowered to improve and protect their health. The health intervention package proposed may aid them by augmenting communication, improving documentation of health encounters, and improving access to, and quality of, GP care. Recruitment strategies to consider for future studies in this population include ensuring potential participants can identify themselves with the individuals used in promotional study material, making direct contact with their families at the start of the study, and closely monitoring the implementation of the educational intervention.

An exploratory review of whole life cycle costing for Malaysia property development

The demand of implementing Whole Life Cycle Costing (WLCC) towards property development has increased since the launch of Value Management Circular 3/2009 by the Economic Planning Unit Malaysia. The circular made compulsory for all public construction projects and programme including property development estimated more than RM 50 Million to conduct WLCC. However, a knowledge gap on WLCC approach still exists and become a barrier among the practitioner in Malaysia particularly in property development industry. The main focus of this paper is to discuss the WLCC approach and introduce the indicator that need to be considered in Malaysia property development.

Gated and Guarded Community (GACOS) in Malaysia : worth or not?

A 'Gated and Guarded Community' has become a popular trend in the recent years, particularly for housing areas. The increasing in population and income has lead to the increase in housing demand. The 1991 Population Census Report showed that Malaysian population has increased with an average yearly rate of 2.7% per year, that is, from 13.74 million people in 1980 to 19.35 million in 1991, followed by 20.69 million in 1995 and increase to 23.27 in year 2000. This is followed by consistent increase in the average population monthly income. Started from 1995 to 1999, the average annual growth rate of mean monthly income in Malaysia is about 5.2 %, from RM2,020.00 in 1995 to RM2,472.00 in 1999 and increasing constantly. This shows that the human growth usually have correlation between demand, income and housing. This paper presents the factors that involved in determined the Gated and Guarded Community Investment in Malaysia either it is worth to invest or otherwise. Hopefully, the results will also indicate that there may be other factors affecting their investment decision besides security and privacy. This paper is actually to draw attention to some practitioner and collect more information in establishing my research analysis.

Influencing innovation in SME’s : from designer to transitional engineer

The following paper presents insights found during an ongoing industry engagement with a family-owned manufacturing SME in Australia. The study seeks to unpack cultural, strategic, product opportunities and challenges available to the firm engaging in a design led approach to innovation. Design led innovation finds new market opportunities to innovate through a holistic perspective of both the internal business operations, focusing on the customer experience and external stakeholders. The action research based methodology consisted of 25 semi-structured interviews, a reflective journal and focus group, all of which were analysed thematically. This paper focuses on the resultant themes of the focus group data constituting a discussion around the best strategies to try and integrate design thinking as a fundamental skill across the company. The main thematic results included the participant’s limited views of themselves (in current roles) as being to create ‘buy-in’ to change initiatives, a preference to act as a group to gain traction in the firm, importance of better defining the problem before reaching a design solution and lastly the time required to implement versus the need for change. These findings are valuable in assisting other family owned firms in managing core growth activities with design and innovation initiatives, particularly in the area of new product development.

Accelerated professional development and peer consultation : two strategies for continuing professional education for nurses

A comparison was made of accelerated professional development (APD) for nurses (n=64), involving peer consultation and reflective practice, and peer consultation alone (n=30). Although APD participants had a higher completion rate, improvements in caregiver behaviors and work environment were not significantly different.

Preparing high achieving English teachers to work in disadvantaged schools : 'I'll teach Shakespeare when I'm 60'

The recent release of the Gonski Review recognises the decline in Australia’s schooling performances over the last decade, noting in particular a distressing increase in the ‘achievement gap’ affecting students from low SES backgrounds (Gonski, 2012). The report details the need for more quality in teachers throughout the schooling system, particularly within the schools with the greatest academic needs. This paper specifically focuses on a group of high-achieving pre-service English teachers. In their last two years of university study, they participated in a program called Exceptional Teachers for Disadvantaged Schools (ETDS), designed to prepare them to work in disadvantaged or low SES schools. We wanted to capture their experiences of teaching in challenging settings during their practicum, and as they prepared to graduate, we wondered what they now felt about teaching English in low SES schools. Using narrative inquiry, we analysed a range of reflective data to gain insight into such things as their initial motivations for entering the teaching profession and how their preconceived expectations may or may not have shifted after practicum experiences in low SES schools. We encouraged open reflection about how they perceived themselves as English teachers.

Cutting on action : interference strategies in contemporary art practice

The domestication of creative software and hardware has been a significant factor in the recent proliferation of still and moving image creation. Booming numbers of amateur image-makers have the resources, skills and ambitions to create and distribute their work on a mass scale. At the same time, contemporary art seems increasingly dominated by ‘post-medium’ practices that adopt and adapt the representational techniques of mass culture, rather than overtly reject or oppose them. As a consequence of this network of forces, the field of image and video production is no longer the exclusive specialty of art and the mass media, and art may no longer be the most prominent watchdog of mass image culture. Intuitively and intentionally, contemporary artists are responding to these shifting conditions. From the position of a creative practitioner and researcher, this paper examines the strategies that contemporary artists use to engage with the changing relationships between image culture, lived experience and artistic practice. By examining the intersections between W.J.T. Mitchell’s detailed understanding of visual literacy and Jacques Derrida’s philosophical models of reading and writing, I identify ‘editing’ as a broad methodology that describes how practitioners creatively and critically engage with the field of still and moving images. My contention is that by emphasising the intersections of looking and making, ‘reading’ and ‘writing’, artists provide crucial jump cuts, pauses and distortions in the medley of our mediated experiences.

Double blind : women as creative practice-led researchers

While the productive relationship between praxis and feminist research has been well established, the situation is more complicated for female artist/researchers in the fraught field of creative practice-led research. Firstly, their research is being conducted in the context of ongoing debate, as Andrea Phillips has summarized, over whether practice-led research has been embraced in order to potentially produce emancipatory knowledge, or whether it is simply the rationalization and quantification of creative processes. Secondly, there is a pervasive paradox whereby, rather than feeling empowered by the process of critical and reflective self-analysis, many women are inhibited by enduring insecurities about the value of their work and/or their ownership of it. The reasons for this appear to be twofold: they are disheartened by the ongoing disproportion of successful women artists, and they are intimidated by the fundamentally masculine discourse surrounding research in the university. Many of these anxieties appear to have been exacerbated by the research quality assessment process, the Excellence in Research for Australia Initiative (ERA). This collaborative paper draws on the authors' experiences as both artist-researchers and educators to contextualize this paradox and also discuss what forms of praxis intervention may be useful in the preparation for, and supervision of, creative practice-led research by women.

Learning and teaching reflection : developing capacities for lifelong learning

Reflection is an essential part of being an effective learner and working as a productive teacher. It enables the learner or teacher to deliberate about the factors that lead to successful learning and teaching for them and/or their students, in a particular place and for a specific purpose, so they can make reasoned and effective choices. This chapter introduces important frameworks that cover a century of thinking around reflection in education, and illustrates how preservice teachers can use these ideas across three phases. First, becoming a reflective learner as a university student to enhance learning and assessment outcomes; second, becoming a reflective teacher to improve classroom teaching and learning outcomes; and third, developing the reflective capacities of primary students so they can enhance their skills for lifelong learning.

'Going live' : establishing the creative attributes of the live multi-camera television professional

In my capacity as a television professional and teacher specialising in multi-camera live television production for over 40 years, I was drawn to the conclusion that opaque or inadequately formed understandings of how creativity applies to the field of live television, have impeded the development of pedagogies suitable to the teaching of live television in universities. In the pursuit of this hypothesis, the thesis shows that television degrees were born out of film studies degrees, where intellectual creativity was aligned to single camera production, and the 'creative roles' of producers, directors and scriptwriters. At the same time, multi-camera live television production was subsumed under the 'mass communication' banner, leading to an understanding that roles other than producer and director are simply technical, and bereft of creative intent or acumen. The thesis goes on to show that this attitude to other television production personnel, for example, the vision mixer, videotape operator and camera operator, relegates their roles to that of 'button pusher'. This has resulted in university teaching models with inappropriate resources and unsuitable teaching practices. As a result, the industry is struggling to find people with the skills to fill the demands of the multi-camera live television sector. In specific terms the central hypothesis is pursued through the following sequenced approach. Firstly, the thesis sets out to outline the problems, and traces the origins of the misconceptions that hold with the notion that intellectual creativity does not exist in live multi-camera television. Secondly, this more adequately conceptualised rendition, of the origins particular to the misconceptions of live television and creativity, is then anchored to the field of examination by presentation of the foundations of the roles involved in making live television programs, using multicamera production techniques. Thirdly, this more nuanced rendition of the field sets the stage for a thorough analysis of education and training in the industry, and teaching models at Australian universities. The findings clearly establish that the pedagogical models are aimed at single camera production, a position that deemphasises the creative aspects of multi-camera live television production. Informed by an examination of theories of learning, qualitative interviews, professional reflective practice and observations, the roles of four multi-camera live production crewmembers (camera operator, vision mixer, EVS/videotape operator and director's assistant), demonstrate the existence of intellectual creativity during live production. Finally, supported by the theories of learning, and the development and explication of a successful teaching model, a new approach to teaching students how to work in live television is proposed and substantiated.