Discharge planning in the emergency department : a comprehensive approach

Discharge planning has become increasingly important, with current trends toward shorter hospital stays, increased health care costs, and more community-based health services. Effective discharge planning ensures the safety and ongoing care for patients,1 and it also benefits health care providers and organizations. It results in shorter hospital stays, fewer readmissions, higher access rates to post-hospitalization services, greater patient satisfaction with the discharge, and improved quality of life and continuity of care.[2] and [3] All acute care patients and their caregivers require some degree of preparation for discharge home—education about their health status, risks, and treatment; help setting health goals and maintaining a good level of self-care; information about community resources; and follow-up appointments and referrals to appropriate community health providers. Inadequate preparation exposes the patient to unnecessary risks of recurrence or complications of the acute complaint, neglect of nonacute comorbidities, mismanagement and side effects of medication, disruption of family and social life, emotional distress, and financial loss.[2], [3] and [4] The result may be re-presentation to the emergency department. It is noteworthy that up to 18% of ED presentations are revisits within 72 hours of the original visit5; many of these are considered preventable.6 It is a primary responsibility of nurses to ensure that patients return to the community adequately prepared and with appropriate support in place. Up to 65% of ED patients are discharged home from the emergency department,7 and the characteristics of the emergency department and its patient population make the provision of a high standard of discharge planning uniquely difficult. In addition, discharge planning is neglected in contemporary emergency nursing—there are no monographs devoted to the subject, and there is little published research. In this article 3 issues are explored: the importance of emergency nurses’ participation in the discharge-planning process, impediments to their participation; and strategies to improve discharge planning in the emergency department.

The aesthetico-ethical subject : another narrative about being ethically responsible

This paper builds on work I presented at the PESA conference in 2007, which moved through both aesthetic and ethical theory to generate a new theory of creative integrity around the issues of autonomy, agency and authenticity. This preliminary theorizing had its origins in my undergraduate ethics classroom where I was confronted with advertising students who resisted the idea of being taught ethics, along with all the philosophical ethical theories traditionally used to do this.

Corporate governance and compliance : preventative measure or just another fad?

In the wake of recent corporate collapses, 'corporate governance' has received unprecedented levels of attention. It can be narrowly defined as how a company is directed and steered. The responsibility of steering a company is entrusted with the board of directors, who become the focus of governance mechanisms.Yet this is not as straightforward as it appears - Australia has experienced massive shifts in business regulations over the past two decades. One innovation in Australian business regulation is 'enforced self-regulation' which combines the benefits of voluntary self-regulation with the coercive power of the State, implemented via a compliance program. A possible hazard of compliance system is that management might treat this responsibility as a 'box ticking' exercise. Therefore effective governance and compliance entails more than setting up internal and regulatory mechanisms; the willingness of various stakeholders to collaborate is crucial. This suggests that managing relationships between stakeholders of an organization is the key to averting corporate collapses.

Preventing sexual violence?

This article critically assesses the main social policy responses to preventing rape following much feminist struggle to make sexual violence a public matter of legitimate concern. It considers the preventative potential of legal measures, anti-violence campaigns waged by feminist and men's groups in the US and Australia, public education campaigns in Schools and Universities, and public awareness campaigns sponsored by the state.We argue that sexual violence is not amenable to quick fix strategies that place responsibility for prevention entirely on individual men or women. While we recognise that responsibilising victims and individualising offenders is consistent with wider global shifts in social policy calling upon individuals to manage their own risk, we argue that the increasing reliance on such neo-liberal social policy is especially problematic in preventing rape. The paper suggests ways to resist this which place greater emphasis on the promotion of sexual ethics; the eroticisation of consent; the reinvention of the norms of romance to include both these, and the complete separation of the psycho-social-symbolic connections between sex and violence, and ultimately the re-evaluation of the cultural expectations of masculinity and femininity.

Knowledge, attitudes and beliefs towards injury prevention : a population based telephone survey

Public knowledge and beliefs about injury prevention are currently poorly understood. A total of 1030 residents in the State of Queensland, Australia responded to questions about injury prevention in or around the home, on the roads, in or on the water, at work, deliberate injury, and responsibility for preventing deliberate injury allowing comparison with published injury prevalence data. Overall the youngest members of society were identified as being the most vulnerable to deliberate injury with young adults accounting for 59% of responses aligning with published data. However, younger adults failed to indicate an awareness of their own vulnerability to deliberate injury in alcohol environments even though 61% of older respondents were aware of this trend. Older respondents were the least inclined to agree that they could make a difference to their own safety in or around the home but were more inclined to agree that they could make a difference to their own safety at work. The results are discussed with a view to using improved awareness of public beliefs about injury to identify barriers to the uptake of injury prevention strategies (e.g. low perceived injury risk) as well as areas where injury prevention strategies may receive public support.

Value-mapping inputs

This research aims to increase understanding of and delivery to qualitative (or intangible) outcomes and impacts of major economic infrastructure projects (i.e. bridges, roads, water infrastructure and the like), and the role of stakeholder engagement in this process.-------- Recent doctoral research completed at the Queensland University of Technology by the author investigated how the principles of corporate responsibility are applied in the construction sector. This related specifically to major economic infrastructure projects (hereafter referred to as major projects), with particular regard to urban transportation projects. One outcome of this past research was a value-mapping framework which enables organisations to track project outcomes to pre-existing corporate objectives, and report on these throughout the project life-cycle. Two recommendations for future research from that work formed the basis for this current research: • How can qualitative measurables be better integrated into decision-making on major economic infrastructure projects? • How can non-contractual stakeholders be more effectively engaged with on these projects? The link between these two areas may relate to the stakeholders’ role in qualitative indicator identification and measurement. This is a key point for future investigation.---------- The aim of this research is thus to further investigate these two areas, with the intent of (i) better defining the research direction; (ii) identifying potential research partners; and (iii) identify possible sources of future funding.

Repositioning an ethic of sustainability in early childhood education, with Reconciliation as central

In this chapter I raise questions about the current scope and purpose of early childhood education for sustainability (ECEfS) and the ways ECEfS is enacted in practice. This is to highlight why social, political and economic areas of concern should be central in ECEfS alongside an environmental focus. Specifically, this chapter establishes the place of Reconciliation in ECEfS because it is one of the most pressing ethical, social, political and economic issues on the Australian landscape. To reposition an ethic of sustainability is to broaden the scope and purpose of sustainability work so that particular regard is given to the place of Reconciliation in ECEfS. An ethic of sustainability is also concerned with the responsibility of non-Indigenous educators to take ownership of Reconciliation work in education curricula and contexts.

The meaning of cancer for Australian Aboriginal women : changing the focus of cancer nursing

Aim: The purpose of the study was to explore why Aboriginal women participate in cancer screening programs but appear reluctant to following-up results, or accept medical advice about treatment. Methods: Interpretive ethnography, a qualitative methodology, was used to explore Aboriginal women’s perception of cancer, and the cultural context in which meaning was constructed and influenced treatment decision. Data collection, which occurred over two years, involved fieldwork, participant-observation, face-to-face interviews and focus groups, in two rural Aboriginal communities. Forty eight interviews were recorded from a cross section of the communities, including cancer survivors and patients, family members, health care providers and other women from the community. Results: Key findings were that Aboriginal women’s had a fearful and fatalistic attitude toward cancer, doubted the efficacy of treatment and carried an enduring ambivalence toward the authority of whiteman’s medicine. The women faced a dilemma of wanting access to cancer treatment options but feared entering hospital or clinics not attuned to their cultural needs. Conclusion: The findings highlight the need for a culture-centred approach that decentres the authority of conventional services and instead gives prominence to Aboriginal cultural values as a focal point in cancer control. It should be the responsibility of cancer nurses and others to engage with their local Aboriginal communities to build relationships that foster an exchange of learning about cultural differences that make a difference to how cancer control is practiced.

Factors contributing to successful public private partnership projects : comparing Hong Kong with Australia and the United Kingdom

Purpose: With the increasing interest in Public Private Partnership (PPP) there is a need to investigate the factors contributing to successful delivery of PPP projects. Design/methodology/approach: An empirical questionnaire survey was conducted in Hong Kong and Australia. The survey respondents were asked to rate eighteen factors which contribute to delivering successful PPP projects. Findings: The findings from this survey were further compared with the results achieved by a previous researcher (Li, 2003) in a similar survey conducted in the United Kingdom. The comparison showed that amongst the top five success factors ranked by Hong Kong respondents, three were also ranked highly by the Australians and British. These success factors included: ‘Commitment and responsibility of public and private sectors’; ‘Strong and good private consortium’; and ‘Appropriate risk allocation and risk sharing’. Originality/value: These success factors were therefore found to be important for contributing to successful PPP projects irrespective of geographical locations.

The researcher’s perspective on procuring public works projects

Purpose: As part of a comprehensive research study looking at implementing PPPs, interviews with experienced researchers were conducted to realize their views on private sector involvement in public works projects. Design / methodology / approach: Amongst these interviews, five were launched with academics from Hong Kong and Australia, and two were conducted with Legislative Councillors of the Hong Kong Special Administration Region (HKSAR) government. Findings: The interview findings show that both Hong Kong and Australian interviewees had previously conducted some kind of research in the field of PPP. The interviewees highlighted that “Different risk profiles” and “Private sector more innovative / efficient” were the main differences between projects that were procured by PPP and traditionally. Other differences include risk transfer. In a PPP arrangement the public sector passes on a substantial amount of the project risks to the private sector, whereas in a traditional case the public sector would take the largest responsibility in bearing these risks. Another common feature of the private sector is that they tend to be more efficient and innovative when compared to the public sector hence their expertise is often reflected in PPP projects. The interviewees agreed that the key performance indicators for PPP projects were unique depending on the individual project. The critical success factors mentioned by both groups of interviewees included “Transparent process”, “Project dependent” and “Market need”. Due to the fact that PPP projects tend to be large scaled costly projects, adequate transparency in the process is necessary in order to demonstrate that a fair selection and tendering process is conducted. A market need for the project is also important to ensure that the project will be financially secure and that the private sector can make a reasonable profit to cover their project expenditure. Originality / value: The findings from this study have enabled a comparative analysis between the views of researchers in two completely different jurisdictions. With the growing popularity to implement PPP projects, it is believed that the results presented in this paper would be of interest to the industry at large.

Towards a culturally appropriate mental health system: Sudanese-Australians' experiences with trauma

Australia is fortunate to welcome approximately 13,000 humanitarian entrants per year, most of whom have experienced protracted violence, hardship and life in refugee camps. The majority of humanitarian migrants were raised in cultural contexts very different to that of Australia, contributing to the increasing diversity of this region. With this diversity comes a responsibility to ensure every Australian receives culturally appropriate mental healthcare. Those who are forced into migration have experienced trauma and the stress of acculturation often compounds this trauma. This study investigated the experience of trauma from the perspectives of Sudanese-Australians. Grounded theory methodology was employed to extract themes from interviews with 15 Sudanese-Australians aged between 19 and 49 years. Results demonstrated four overarching themes: support, religion, strength and new possibilities. The data within these themes are compared and contrasted with previous literature that has examined notions of trauma, distress and growth in western populations. Conclusions drawn from these results highlight the need to build inclusive practices that support diversity into existing trauma services in Australia.

Curtains and carnality : processural seductions in eighteenth century text and space

Libertine erotic novellas included a number of seductive descriptions of unfolding spaces often seen through the eyes of a narrator. Instructional volumes such as Point de lendermain by Vivant Denon (1777) aimed at the sexual education of young women and the titillation of men also followed suit. Similarly architectural theory such as Le Camus de Mézières’, The Genius of Architecture (1780) also promoted the sensuous and seductive aspects of surfaces and spatial arrangements. In the erotic settings of the cabinet, descriptions of curtains generate as much arousal as the outline of a naked body, and for some players it is the space that is desired above their lover.

The carrying capacity imperative : assessing regional carrying capacity methodologies for sustainable land-use planning

The global impact of an ever-increasing population-base combined with dangerously depleted natural resources highlights the urgent need for changes in human lifestyles and land-use patterns. To achieve more equitable and sustainable land use, it is imperative that populations live within the carrying capacity of their natural assets in a manner more accountable to and ethically responsible for the land which sustains them. Our society’s very survival may well depend on worldwide acceptance of the carrying capacity imperative as a principle of personal, political, economic, educational and planning responsibility. This theoretically-focused research identifies, examines and compares a range of methodological approaches to carrying capacity assessment and considers their relevance to future spatial planning. It also addresses existing gaps in current methodologies and suggests avenues for improvement. A set of eleven key criteria are employed to compare various existing carrying capacity assessment models. These criteria include whole-systems analysis, dynamic responses, levels of impact and risk, systemic constraints, applicability to future planning and the consideration of regional and local boundary delineation. This research finds that while some existing methodologies offer significant insights into the assessment of population carrying capacities, a comprehensive model is yet to be developed. However, it is suggested that by combining successful components from various authors, and collecting a range of interconnected data, a practical and workable systems-based model may be achievable in the future.

The Changing world and service problems in bankruptcy

In an age where financial transactions are conducted worldwide and mobility of citizens throughout the world is common, lawyers seeking to serve Bankruptcy Notices and Creditor’s Petitions encounter many problems. To assist lawyers in overcoming some of the service problems that are arising as a result of this changing world, a number of recent cases are considered that highlight a number of issues, including American Express Australia Limited v Michaels [2010] FMCA 103, Deputy Commissioner of Taxation v Barnes (2008) 70 ATR 776; [2008] FMCA 7, Battenberg v Restom & Ors (2005) 223 ALR 692; upheld by the Full Federal Court in Battenberg v Restrom and Ors (2006) 149 FCR 128 at 133; [2006] FCAFC 20 and Envee Energy Pty Ltd (In Liquidation) v Stockford [2007] FMCA 1426. While the fact situation of every bankruptcy case will differ, recent decisions may assist lawyers in dealing effectively with bankruptcy matters in these times of transition. Lawyers can facilitate completion of the litigious process within the relevant legislative framework in order to satisfy their responsibility to clients and to the Court by considering this case law.

Listen and learn

The communities located adjacent to and around the Airport City are composed of diverse interests and cultures that often have little to do with the airport and its global service functions. Yet, as most airport managers know, these communities can have a significant impact on airport operations and land use. Community engagement is an essential element to airport planning and management that is often underplayed and given only a token effort. In order for Airport Cities to realize their full potential in global and national markets as well as assume an appropriate level of corporate responsibility there needs to be a strong and enduring connections to local and regional communities. Through a series of nationally held workshops throughout Australia and internationally, we have reviewed the complex relationship between airports and their surrounding communities. We argue the following engagement elements improve both communication and relationships with local communities and must be actively nurtured, developed and pursued by airport managers: connectivity, collaboration and citizenry.