Developing the Primary Palliative Care Workforce in Australia

Current healthcare models promote the equitable provision of palliative care to oncology patients with advancing disease, in the setting of their usual care, often in conjunction with anti-cancer therapies. This has resulted in specialist cancer services, as well as primary care across metropolitan, rural and remote communities, being called upon to integrate palliative care principles into their practice. To meet this increased demand for skilled health care professionals several national strategies have been initiated over the last five years. In this paper two projects are discussed in detail: the Palliative Care Curriculum for Undergraduates and the Program of Experience in the Professional Approach.

Field and Service Robotics Results of the 5th International Conference

The 5th International Conference on Field and Service Robotics (FSR05) was held in Port Douglas, Australia, on 29th - 31st July 2005, and brought together the worlds' leading experts in field and service automation. The goal of the conference was to report and encourage the latest research and practical results towards the use of field and service robotics in the community with particular focus on proven technology. The conference provided a forum for researchers, professionals and robot manufacturers to exchange up-to-date technical knowledge and experience. Field robots are robots which operate in outdoor, complex, and dynamic environments. Service robots are those that work closely with humans, with particular applications involving indoor and structured environments. There are a wide range of topics presented in this issue on field and service robots including: Agricultural and Forestry Robotics, Mining and Exploration Robots, Robots for Construction, Security & Defence Robots, Cleaning Robots, Autonomous Underwater Vehicles and Autonomous Flying Robots. This meeting was the fifth in the series and brings FSR back to Australia where it was first held. FSR has been held every 2 years, starting with Canberra 1997, followed by Pittsburgh 1999, Helsinki 2001 and Lake Yamanaka 2003.

The legal framework of the Australian health system

This chapter is about the role of law in the creation and operation of Australian health systems. Accordingly, this chapter discusses how law regulates the way in which health services in Australia are funded, organised, regulated, managed, operated and governed. (The question of how health professionals are regulated is discussed in Chapter 15.) Although the focus of much of health law is on legal mechanisms for the resolution of disputes or disagreements between the state, health providers, professionals, patients and families and friends, and through dispute resolutions processes setting standards for practice, these are only some of the “jobs” that health law performs. In health systems where the state undertakes a significant role in regulating, funding, managing and providing health services, health law also performs an important constitutive function. Health law declares the values upon which the health system is based, shapes social processes to achieve public ends and provides a structure for the complex interactions that occur within a modern health system. Health law regulates decision-makers in health systems by establishing who has the power to participate in decisions and in what circumstances, establishing processes through which decisions are made and creating mechanisms for decision-makers to be held publicly accountable. It is this broader constitutive function of health law that is a primary focus of much of this chapter — how and why governments use their legislative powers to structure and shape the health system.

Fashion design research : research methodologies for emerging researchers [Abstract]

This paper attempts to address some fundamental issues faced by new and emerging researchers in the discipline of Fashion design. A culture of patchwork research methodology appears to have become the norm in an attempt to ‘fit’ fashion design research into an academic paradigm for the examination of readers from more traditional research fields such as Arts, Humanities, Science and Philosophy. Two key questions are discussed here; is it appropriate for fashion researchers to adopt and adapt existing research methodologies to find a scholarly, academic voice? Secondly; do these methodologies enable fashion design research to be effectively disseminated to professionals and fellow researchers within the discipline of fashion design?

A decision support system for sustainable urban development : the integrated land use and transportation indexing model

Broad, early definitions of sustainable development have caused confusion and hesitation among local authorities and planning professionals. This confusion has arisen because loosely defined principles of sustainable development have been employed when setting policies and planning projects, and when gauging the efficiencies of these policies in the light of designated sustainability goals. The question of how this theory-rhetoric-practice gap can be filled is the main focus of this chapter. It examines the triple bottom line approach–one of the sustainability accounting approaches widely employed by governmental organisations–and the applicability of this approach to sustainable urban development. The chapter introduces the ‘Integrated Land Use and Transportation Indexing Model’ that incorporates triple bottom line considerations with environmental impact assessment techniques via a geographic, information systems-based decision support system. This model helps decision-makers in selecting policy options according to their economic, environmental and social impacts. Its main purpose is to provide valuable knowledge about the spatial dimensions of sustainable development, and to provide fine detail outputs on the possible impacts of urban development proposals on sustainability levels. In order to embrace sustainable urban development policy considerations, the model is sensitive to the relationship between urban form, travel patterns and socio-economic attributes. Finally, the model is useful in picturing the holistic state of urban settings in terms of their sustainability levels, and in assessing the degree of compatibility of selected scenarios with the desired sustainable urban future.

An exploratory study of online social networking within a Doctorate of Education program

The professional doctorate is a degree that is specifically designed for professionals investigating real-world problems and relevant issues for a profession, industry and/or the community. The exploratory study on which this paper is based sought to track the scholarly skill development of a cohort of professional doctoral students who commenced their course in January 2008 at an Australian university. Via an initial survey and two focus groups held six months apart, the study aimed to determine if there had been any qualitative shifts in students’ understandings, expectations and perceptions regarding their developing knowledge and skills. Three key findings that emerged from this study were: (i) the appropriateness of using a blended learning approach in this professional doctoral program; (ii) the challenges of using wikis as an online technology for creating communities of practice; and (iii) the transition from professional to scholar is a process that requires the guided support inherent in the design of this particular doctorate of education program.

Physical inactivity, appetite regulation and obesity

In a consumerist society obsessed with body image and thinness, obesity levels have reached an all-time high. This multi-faceted book written by a range of experts, explores the social, cultural, clinical and psychological factors that lie behind the Obesity Epidemic . It is required reading for the many healthcare professionals dealing with the effects of obesity and for anyone who wants to know more about the causes of weight gain and the best ways of dealing with it. Fat Matters covers a range of issues from sociology through medicine to technology. This is not a book for the highly specialised expert. Rather it is a book that shows the diversity of approaches to the phenomenon of obesity, tailored to the reader who wants to be up-to-date and well-informed on a subject that is possibly as frequently discussed and as misunderstood as the weather.

Children, Obesity and Exercise: Prevention, Treatment and Management of Childhood and Adolescent Obesity

Throughout the developed world there is an increasing prevalence of childhood obesity. Because of this increase, and awareness of the risks to long term health that childhood obesity presents, the phenomena is now described by many as a global epidemic. Children, Obesity and Exercise provides sport, exercise and medicine students and professionals with an accessible and practical guide to understanding and managing childhood and adolescent obesity. It covers: overweight, obesity and body composition; physical activity, growth and development; psycho-social aspects of childhood obesity; physical activity behaviours; eating behaviours; measuring childrens behaviour; interventions for prevention and management of childhood obesity. Children, Obesity and Exercise addresses the need for authoritative advice and innovative approaches to the prevention and management of this chronic problem.

Collaborative voices: Ongoing reflections on cultural competency and the health care of Australian Indigenous people

The issue of cultural competency in health care continues to be a priority in Australia for health and human services professionals. Cultural competence in caring for Aboriginal and Torres Strait Islander peoples is of increasing interest, and is a priority in closing the gap in health disparities between Indigenous and non-Indigenous Australians. Through a collaborative conversation, the authors draw on a case study, personal experience and the literature to highlight some of the issues associated with employing culturally appropriate, culturally safe and culturally competent approaches when caring for Aboriginal and Torres Strait Islander peoples. The intent of this article is to encourage discussion on the topic of cultural competency, and to challenge health professionals and academics to think and act on racism, colonialism, historical circumstances and the political, social, economic, and geographical realms in which we live and work, and which all impact on cultural competency.

Managing illegal street racing and associated risky driving behaviour : An Australian perspective

Illegal street racing has received increased attention in recent years from the media, governments and road safety professionals. At the same time, there has been a shift from treating illegal street racing as a public nuisance issue to a road safety problem in Australia, as this behaviour now attracts a penalty of increased periods of vehicle impoundment leading to permanent vehicle forfeiture for repeat offences. This severe vehicle sanction is typically applied to repeat drink driving offenders and drivers who breach suspensions and disqualifications in North American jurisdictions, but was first introduced in Australia to deal with illegal street racing and associated risky driving behaviours, grouped together under the label of ‘hooning’ in Australian jurisdictions. This paper describes how Australian jurisdictions are dealing with this issue. The research described in this paper drew on multiple data sources to explore illegal street racing and the management of this issue in Australia. First, the paper reviews the relevant legislation in each Australian state to describe the cross-jurisdictional similarities and differences in approaches. It also describes some results from focus group discussions and a quantitative online survey with drivers who self-report engaging in illegal street racing and associated behaviours in Queensland, Australia. It was found that approaches to dealing with illegal street racing and associated risky driving behaviours in each Australian state are similar, with increasing periods of vehicle impoundment (leading to vehicle forfeiture) applied to repeat hooning offences within prescribed periods. Participants in the focus groups and respondents to the questionnaire generally felt these penalty periods were severe, with perceptions of severity increasing with the length of the penalty period. It was concluded that there is a need for each jurisdiction to objectively evaluate the effectiveness of their vehicle impoundment and forfeiture programs for hooning. These evaluations should compare the relative costs of these programs (e.g., enforcement, unrecovered towing and storage fees, and court costs) to the observed benefits (e.g., reduction in target behaviours, reduction in community complaints, and reduction in the number and severity of associated crashes).

Wellness in older adults

Understanding perception of wellness in older adults is a question to be understood against the backdrop of concerns about whether global ageing and the ‘bulge’ of ageing baby boomers will increase health care cost beyond what modern economies can deal with. Older adults who age in a healthy way and who take responsibility for their own health offer a positive alternative and change the perception that older adults are a burden on their society’s health system. The concept of successful ageing introduced by Rowe and Kahn (1987; 1997) suggested that older adults age successfully if they avoid disease and disability, maintain high cognitive and physical functioning and remain actively engaged with life. This concept, however, did not reflect older adults’ own perceptions of what constitutes successful ageing or how perceptions of wellness or health-related quality of life influenced the older adult’s understanding of his or her own health and ageing. A research project was designed to examine older adults’ perceptions of wellness in order to gain an understanding of the factors that influence perception of their own wellness. Specifically, the research wanted to explore two aspects: whether belonging to a unique organisation, in this instance a Returned Services Club, influenced perceptions of wellness; and whether there are significant gender differences for the perception of wellness. A mixed method project with two consecutive studies was designed to answer these questions: a quantitative survey of members of a Returned Services Club and of the surrounding community in Queensland, Australia, and a qualitative study conducting focus groups to explore findings of the survey. The results of the survey were used to determine the composition of the focus groups. The participants for the first study, (N=257), community living adults 65 years and older, were chosen from the membership role of a Returned Services Club or recruited by personal approach from the community surrounding the Services Club. Participants completed a survey that consisted of a perception of wellness instrument, a health-related quality of life instrument, and questions on morbidities, modifiable life style factors and demographics. Data analysis found that a number of individual factors influenced perception of wellness and health-related quality of life. Positive influences were independent mobility, exercise and gambling at non-hazardous levels, and negative influences were hearing loss, memory problems, chronic disease and being single. Membership of the Services Club did not contribute to perception of wellness beyond being a member of a social group. While there may have been an expectation that members of an organisation that is traditionally associated with high alcohol use and problematic gambling may have lower perceptions of wellness, this study suggested that the negative influences may have been counteracted by the positive effects of social interaction, thus having neither negative nor positive influences on perception of wellness. There were significant differences in perception of wellness and in health-related quality of life for women and men. The most significant difference was for women aged 85-90 who had significantly lower scores for perception of wellness than men or than any other age group. This result was the impetus for conducting focus groups with adults aged 85-90 years of age. Focus groups were conducted with 24 women and four men aged 85-90 to explore the survey findings for this age group. Results from the focus groups indicated that for older adults perception of wellness was a multidimensional construct of more complexity than indicated by the survey instrument. Elite older women (women over 85 years of age) related their perception of wellness to their ability to do what they wanted to do, and what they wanted to do significantly more than anything else, was to stay connected to family, friends and the community to which they belonged. From the focus group results it appeared that elite older women identified with the three elements of successful ageing – low incidence of disability and disease, high physical and cognitive functioning, and active engagement with life – but not in a flat structure. It appears that for elite older women good physical and mental health function to enable social connectedness. It is the elements of health that impact on the ability to do what they wanted to do that were identified as key factors: independent mobility, hearing and memory - factors that impact on the ability to interact socially. These elements were only identified when they impacted on the person’s ability to do what they wanted to do, for example mobility problems that were managed were not considered a problem. The study also revealed that older women use selection, optimisation and compensation to meet their goal of staying socially connected. The shopping centre was a key factor in this goal and older women used shopping centres to stay connected to the community and for exercise as well as shopping. Personal and public safety and other environmental concerns were viewed in the same context of enabling or disabling social connectedness. This suggested that for elite older women the model of successful ageing was hierarchical rather than flat, with social connectedness at the top, supported by cognitive functioning and good physical and mental health. In conclusion, this research revealed that perception of wellness in older adults is a complex, multidimensional construct. For older adults good health is related to social connectedness and is not a goal in itself. Health professionals and the community at large have a responsibility to take into account the ability of the older adult to stay socially connected to their community and to enable this, if the goal is to keep older adults healthy for as long as possible. Maintaining or improving perception of wellness in older adults will require a broad biopsychosocial approach that utilises findings such as older adults’ use of shopping centres for non-shopping purposes, concerns about personal and environmental safety and supporting older adults to maintain or improve their social connectedness to their communities.

Developing regional precise positioning services using the legacy and future GNSS receivers

This paper presents an overview of technical solutions for regional area precise GNSS positioning services such as in Queensland. The research focuses on the technical and business issues that currently constrain GPS-based local area Real Time Kinematic (RTK) precise positioning services so as to operate in future across larger regional areas, and therefore support services in agriculture, mining, utilities, surveying, construction, and others. The paper first outlines an overall technical framework that has been proposed to transition the current RTK services to future larger scale coverage. The framework enables mixed use of different reference GNSS receiver types, dual- or triple-frequency, single or multiple systems, to provide RTK correction services to users equipped with any type of GNSS receivers. Next, data processing algorithms appropriate for triple-frequency GNSS signals are reviewed and some key performance benefits of using triple carrier signals for reliable RTK positioning over long distances are demonstrated. A server-based RTK software platform is being developed to allow for user positioning computations at server nodes instead of on the user's device. An optimal deployment scheme for reference stations across a larger-scale network has been suggested, given restrictions such as inter-station distances, candidates for reference locations, and operational modes. For instance, inter-station distances between triple-frequency receivers can be extended to 150km, which doubles the distance between dual-frequency receivers in the existing RTK network designs.

Driver knowledge about road fatalities in Australia

The term “road toll” quantifies road deaths and attracts media attention, particularly during Easter/Christmas holiday periods. Since the media focuses considerable attention on this issue, we might expect that this would translate into awareness among drivers the number of people killed, which in turn, would hopefully encourage safer driving. Road safety professionals are cognisant of road toll trends but there is little information available to indicate awareness of road fatalities among the general population. This research investigated awareness of fatalities on Queensland and Australian roads among Queensland drivers.

Parents’ self-efficacy, outcome expectations, and self-reported task performance when managing atopic dermatitis in children: Instrument reliability and validity

BACKGROUND: Support and education for parents faced with managing a child with atopic dermatitis is crucial to the success of current treatments. Interventions aiming to improve parent management of this condition are promising. Unfortunately, evaluation is hampered by lack of precise research tools to measure change. OBJECTIVES: To develop a suite of valid and reliable research instruments to appraise parents' self-efficacy for performing atopic dermatitis management tasks; outcome expectations of performing management tasks; and self-reported task performance in a community sample of parents of children with atopic dermatitis. METHODS: The Parents' Eczema Management Scale (PEMS) and the Parents' Outcome Expectations of Eczema Management Scale (POEEMS) were developed from an existing self-efficacy scale, the Parental Self-Efficacy with Eczema Care Index (PASECI). Each scale was presented in a single self-administered questionnaire, to measure self-efficacy, outcome expectations, and self-reported task performance related to managing child atopic dermatitis. Each was tested with a community sample of parents of children with atopic dermatitis, and psychometric evaluation of the scales' reliability and validity was conducted. SETTING AND PARTICIPANTS: A community-based convenience sample of 120 parents of children with atopic dermatitis completed the self-administered questionnaire. Participants were recruited through schools across Australia. RESULTS: Satisfactory internal consistency and test-retest reliability was demonstrated for all three scales. Construct validity was satisfactory, with positive relationships between self-efficacy for managing atopic dermatitis and general perceived self-efficacy; self-efficacy for managing atopic dermatitis and self-reported task performance; and self-efficacy for managing atopic dermatitis and outcome expectations. Factor analyses revealed two-factor structures for PEMS and PASECI alike, with both scales containing factors related to performing routine management tasks, and managing the child's symptoms and behaviour. Factor analysis was also applied to POEEMS resulting in a three-factor structure. Factors relating to independent management of atopic dermatitis by the parent, involving healthcare professionals in management, and involving the child in the management of atopic dermatitis were found. Parents' self-efficacy and outcome expectations had a significant influence on self-reported task performance. CONCLUSIONS: Findings suggest that PEMS and POEEMS are valid and reliable instruments worthy of further psychometric evaluation. Likewise, validity and reliability of PASECI was confirmed.

A prototype system for the digital lodgement of spatial data

This dissertation develops the model of a prototype system for the digital lodgement of spatial data sets with statutory bodies responsible for the registration and approval of land related actions under the Torrens Title system. Spatial data pertain to the location of geographical entities together with their spatial dimensions and are classified as point, line, area or surface. This dissertation deals with a sub-set of spatial data, land boundary data that result from the activities performed by surveying and mapping organisations for the development of land parcels. The prototype system has been developed, utilising an event-driven paradigm for the user-interface, to exploit the potential of digital spatial data being generated from the utilisation of electronic techniques. The system provides for the creation of a digital model of the cadastral network and dependent data sets for an area of interest from hard copy records. This initial model is calibrated on registered control and updated by field survey to produce an amended model. The field-calibrated model then is electronically validated to ensure it complies with standards of format and content. The prototype system was designed specifically to create a database of land boundary data for subsequent retrieval by land professionals for surveying, mapping and related activities. Data extracted from this database are utilised for subsequent field survey operations without the need to create an initial digital model of an area of interest. Statistical reporting of differences resulting when subsequent initial and calibrated models are compared, replaces the traditional checking operations of spatial data performed by a land registry office. Digital lodgement of survey data is fundamental to the creation of the database of accurate land boundary data. This creation of the database is fundamental also to the efficient integration of accurate spatial data about land being generated by modem technology such as global positioning systems, and remote sensing and imaging, with land boundary information and other information held in Government databases. The prototype system developed provides for the delivery of accurate, digital land boundary data for the land registration process to ensure the continued maintenance of the integrity of the cadastre. Such data should meet also the more general and encompassing requirements of, and prove to be of tangible, longer term benefit to the developing, electronic land information industry.