Micro-business community responsibility – approaches, motivations and barriers

Micro-businesses, those with fewer than five employees, have a significant impact on the economy. These very small players represent 89% of all Australian businesses and, collectively, they provide 17% of the nation’s private sector employment. They are ubiquitous in Australia as in many other nations, embedded in local communities and therefore well placed to influence community wellbeing. Surprisingly, very little is known about micro-Business Community Responsibility (mBCR), the micro-business equivalent of Small Business Social Responsibility (SBSR) and Corporate Social Responsibility (CSR). Most national data available on business support for community wellbeing does not separately identify micro-business contributions. In this study an exploratory approach informed by business ethics theory was taken. Data from 36 semi-structured interviews was analysed to examine perceived mBCR approaches, motivations and barriers. The sample for this study was a mix of micro-business owner-operators situated in suburban shopping areas in Brisbane. Three types of mBCR emerged. All types are at least partly driven by enlightened selfinterest (ESI). However of the three mBCR types, two combine ESI with other approaches. One type combines ESI and philanthropic approaches to mBCR, and the other combines ESI with social entrepreneurial approaches to mBCR. The combination of doing business and doing good for many micro-business owneroperators, suggests mBCR may be a significant, yet unrecognised component of the third sector social economy.

Development and evaluation of an integrated clinical learning model to inform continuing education for acute care nurses

Background Significant ongoing learning needs for nurses have occurred as a direct result of the continuous introduction of technological innovations and research developments in the healthcare environment. Despite an increased worldwide emphasis on the importance of continuing education, there continues to be an absence of empirical evidence of program and session effectiveness. Few studies determine whether continuing education enhances or develops practice and the relative cost benefits of health professionals’ participation in professional development. The implications for future clinical practice and associated educational approaches to meet the needs of an increasingly diverse multigenerational and multicultural workforce are also not well documented. There is minimal research confirming that continuing education programs contribute to improved patient outcomes, nurses’ earlier detection of patient deterioration or that standards of continuing competence are maintained. Crucially, evidence-based practice is demonstrated and international quality and safety benchmarks are adhered to. An integrated clinical learning model was developed to inform ongoing education for acute care nurses. Educational strategies included the use of integrated learning approaches, interactive teaching concepts and learner-centred pedagogies. A Respiratory Skills Update education (ReSKU) program was used as the content for the educational intervention to inform surgical nurses’ clinical practice in the area of respiratory assessment. The aim of the research was to evaluate the effectiveness of implementing the ReSKU program using teaching and learning strategies, in the context of organisational utility, on improving surgical nurses’ practice in the area of respiratory assessment. The education program aimed to facilitate better awareness, knowledge and understanding of respiratory dysfunction in the postoperative clinical environment. This research was guided by the work of Forneris (2004), who developed a theoretical framework to operationalise a critical thinking process incorporating the complexities of the clinical context. The framework used educational strategies that are learner-centred and participatory. These strategies aimed to engage the clinician in dynamic thinking processes in clinical practice situations guided by coaches and educators. Methods A quasi experimental pre test, post test non–equivalent control group design was used to evaluate the impact of the ReSKU program on the clinical practice of surgical nurses. The research tested the hypothesis that participation in the ReSKU program improves the reported beliefs and attitudes of surgical nurses, increases their knowledge and reported use of respiratory assessment skills. The study was conducted in a 400 bed regional referral public hospital, the central hub of three smaller hospitals, in a health district servicing the coastal and hinterland areas north of Brisbane. The sample included 90 nurses working in the three surgical wards eligible for inclusion in the study. The experimental group consisted of 36 surgical nurses who had chosen to attend the ReSKU program and consented to be part of the study intervention group. The comparison group included the 39 surgical nurses who elected not to attend the ReSKU program, but agreed to participate in the study. Findings One of the most notable findings was that nurses choosing not to participate were older, more experienced and less well educated. The data demonstrated that there was a barrier for training which impacted on educational strategies as this mature aged cohort was less likely to take up educational opportunities. The study demonstrated statistically significant differences between groups regarding reported use of respiratory skills, three months after ReSKU program attendance. Between group data analysis indicated that the intervention group’s reported beliefs and attitudes pertaining to subscale descriptors showed statistically significant differences in three of the six subscales following attendance at the ReSKU program. These subscales included influence on nursing care, educational preparation and clinical development. Findings suggest that the use of an integrated educational model underpinned by a robust theoretical framework is a strong factor in some perceptions of the ReSKU program relating to attitudes and behaviour. There were minimal differences in knowledge between groups across time. Conclusions This study was consistent with contemporary educational approaches using multi-modal, interactive teaching strategies and a robust overarching theoretical framework to support study concepts. The construct of critical thinking in the clinical context, combined with clinical reasoning and purposeful and collective reflection, was a powerful educational strategy to enhance competency and capability in clinicians.

Tailoring Consumer Resources to Enhance Self-Care in Chronic Heart Failure

Background Chronic heart failure (CHF) is associated with high hospitalisation and mortality rates and debilitating symptoms. In an effort to reduce hospitalisations and improve symptoms individuals must be supported in managing their condition. Patients who can effectively self-manage their symptoms through lifestyle modification and adherence to complex medication regimens will experience less hospitalisations and other adverse events. Aim The purpose of this paper is to explain how providing evidence-based information, using patient education resources, can support self-care. Discussion Self-care relates to the activities that individuals engage in relation to health seeking behaviours. Supporting self-care practices through tailored and relevant information can provide patients with resources and advice on strategies to manage their condition. Evidence-based approaches to improve adherence to self-care practices in patients with heart failure are not often reported. Low health literacy can result in poor understanding of the information about CHF and is related to adverse health outcomes. Also a lack of knowledge can lead to non-adherence with self-care practices such as following fluid restriction, low sodium diet and daily weighing routines. However these issues need to be addressed to improve self-management skills. Outcome Recently the Heart Foundation CHF consumer resource was updated based on evidence-based national clinical guidelines. The aim of this resource is to help consumers improve understanding of the disease, reduce uncertainty and anxiety about what to do when symptoms appear, encourage discussions with local doctors, and build confidence in self-care management. Conclusion Evidence-based CHF patient education resources promote self-care practices and early detection of symptom change that may reduce hospitalisations and improve the quality of life for people with CHF.

Response : letter to the editor by Al-Azri and Al-Maniri

Firstly, the authors would like to thank the editor for the opportunity to respond to Dr Al-Azri’s and Dr Al-Maniri’s letter. Secondly, while the current authors also accept that deterrence-based approaches should act as only one corner-stone of a suite of interventions and public policy initiatives designed to improve road safety, deterrence-based approaches have nonetheless consistently proven to be a valuable resource to improve road safety. Dr Al-Azri and Dr Al-Maniri reinforce their assertion about the limited utility of deterrence by citing drink driving research, and the issue of drink driving is particularly relevant within the current context given that the problem of driving after drinking has historically been addressed through deterrence-based approaches. While the effectiveness of deterrence-based approaches to reduce drink driving will always be dependent upon a range of situational and contextual factors (including police enforcement practices, cultural norms, etc), the utilisation of this approach has proven particularly effective within Queensland, Australia. For example, a relatively recent comprehensive review of Random Breath Testing in Queensland demonstrated that this initiative not only had a deterrent impact upon self-reported intentions to drink and drive, but was also found to have significantly reduced alcohol-related fatalities in the state. However, the authors agree that deterrence-based approaches can be particularly transient and thus require constant “topping up” not least through sustained public reinforcement, which was clearly articulated in the seminal work by Homel.

Resisting contradictions : non-Indigenous pre-service teacher responses to critical Indigenous studies

The study examines non-Indigenous pre-service teacher responses to the authorisation of Indigenous knowledge perspectives in compulsory Indigenous studies with a primary focus on exploring the nature and effects of resistance. It draws on the philosophies of the Japanangka teaching and research paradigm (West, 2000), relationship theory (Graham, 1999), Indigenist methodologies and decolonisation approaches to examine this resistance. A Critical Indigenist Study was employed to investigate how non-Indigenous pre-service teachers managed their learning, and how they articulated shifts in resistance as they progressed through their studies. This study explains resistance to compulsory Indigenous and how it can be targeted by Indigenist Standpoint Pedagogy. The beginning transformations in pre-service teacher positioning in relation to Australian history, contemporary educational practice, and professional identity was also explored.

Feasibility of using health data sources to inform product safety surveillance in Queensland : a report for the Queensland Injury Prevention Council

This report provides an evaluation of the current available evidence-base for identification and surveillance of product-related injuries in children in Queensland. While the focal population was children in Queensland, the identification of information needs and data sources for product safety surveillance has applicability nationally for all age groups. The report firstly summarises the data needs of product safety regulators regarding product-related injury in children, describing the current sources of information informing product safety policy and practice, and documenting the priority product surveillance areas affecting children which have been a focus over recent years in Queensland. Health data sources in Queensland which have the potential to inform product safety surveillance initiatives were evaluated in terms of their ability to address the information needs of product safety regulators. Patterns in product-related injuries in children were analysed using routinely available health data to identify areas for future intervention, and the patterns in product-related injuries in children identified in health data were compared to those identified by product safety regulators. Recommendations were made for information system improvements and improved access to and utilisation of health data for more proactive approaches to product safety surveillance in the future.

It’s not me, it’s you : a participant observation case study of the self-publishing musician in the 21st century

This thesis explores the business environment for self-publishing musicians at the end of the 20th century and the start of the 21st century from theoretical and empirical standpoints. The exploration begins by asking three research questions: what are the factors affecting the sustainability of an Independent music business; how many of those factors can be directly influenced by an Independent musician in the day-to-day operations of their musical enterprise; and how can those factors be best manipulated to maximise the benefit generated from digital music assets? It answers these questions by considering the nature of value in the music business in light of theories of political economy, then quantitative and qualitative examinations of the nature of participation in the music business, and then auto-ethnographic approaches to the application of two technologically enabled tools available to Independent musicians. By analyzing the results of five different examinations of the topic it answers each research question with reference to four sets of recurring issues that affect the operations of a 21st century music business: the musicians’ personal characteristics, their ability to address their business’s informational needs; their ability to manage the relationships upon which their business depends; and their ability to resolve the remaining technological problems that confront them. It discusses ways in which Independent self-publishing musicians can and cannot deal with these four issues on a day-to-day basis and highlights aspects for which technological solutions do not exist as well as ways in which technology is not as effective as has been claimed. It then presents a self-critique and proposes some directions for further study before concluding by suggesting some common features of 21st century Independent music businesses. This thesis makes three contributions to knowledge. First, it provides a new understanding of the sources of musical value, shows how this explains changes in the music industries over the past 30 years, and provides a framework for predicting future developments in those industries. Second, it shows how the technological discontinuity that has occurred around the start of the 21st century has and has not affected the production and distribution of digital cultural artefacts and thus the attitudes, approaches, and business prospects of Independent musicians. Third, it argues for new understandings of two methods by which self-publishing musicians can grow a business using production methods that are only beginning to be more broadly understood: home studio recording and fan-sourced production. Developed from the perspective of working musicians themselves, this thesis identifies four sets of issues that determine the probable success of musicians’ efforts to adopt new technologies to capture the value of the musicians’ creativity and thereby foster growth that will sustain an Independent music business in the 21st century.

A way forward to managing the transition to professional practice for beginning teachers

The high attrition rate of beginning teachers in Australia and overseas is well-documented. This trend is easily understood as many beginning teachers enter the profession with little support or mentoring (Department of Education, Science and Training (DEST), 2002; Herrington & Herrington, 2004; Ramsey, 2000). Continual calls for more comprehensive approaches to teacher induction in which universities and employing bodies share the responsibilities of the transition to professional practice (House of Representatives Standing Committee on Education and Vocational Training, 2007) have, to date, largely been ignored. This paper reports on a trial project conducted at a university in south-east Queensland, Australia that addresses these shortfalls. The aim of the project is to facilitate and support the development of high quality teachers and teaching through an extended model of teacher preparation. The model comprises a 1+2 program of formal teacher preparation: a one-year teacher education course (the Graduate Diploma in Education), followed by a comprehensive two year program of workplace induction and ongoing professional learning tailored to meet graduate and employer needs. This paper reports on graduating students’ perceptions of their preparedness to teach as they transition from the Graduate Diploma in Education program to professional practice. The study concludes that innovative programs, including university-linked, ongoing professional learning support for teacher education graduates, may provide the way forward for enhancing the transition to practice for beginning teachers.

[Letter to the Editor] Telemonitoring in Patients with Heart Failure

To the Editor: Chaudhry et al. suggest that enhanced support in the use of a telephone-based interactive voice-response system for patients recently discharged after worsening heart failure does not improve outcomes. This finding is broadly consistent with previous systematic reviews of telephone support1 and contrasts with the substantial effect observed with home telemonitoring of vital signs in similar populations.1 The treatment of patients in the control group was excellent, but unrepresentative of usual clinical care and not inferior to the treatment of patients receiving enhanced support. Monitoring alone is unlikely to improve outcomes but may do so when it improves prescription of or adherence to lifesaving treatments. Given enough resources, traditional methods for delivering care may render an interactive voice-response system or a home telemonitoring system ineffective. Nonetheless, there may be more cost-efficient approaches to ensuring quality care.2 Informal post hoc addition of these data to our recent meta-analysis of telephone support1 does not substantially alter the point estimates for death from any cause or heart-failure−related hospitalizations, but it does nullify the small benefit in hospitalizations for any cause, which may not be reduced by a heart-failure−focused intervention.1 Original article: Telemonitoring in Patients with Heart Failure NEJM. December 9, 2010 | S.I. Chaudhry and Others

A way forward to managing the transition to professional practice for beginning teachers

The high attrition rate of beginning teachers in Australia and overseas is well-documented. This trend is easily understood as many beginning teachers enter the profession with little support or mentoring (Department of Education, Science and Training (DEST), 2002; Herrington & Herrington, 2004; Ramsey, 2000). Continual calls for more comprehensive approaches to teacher induction in which universities and employing bodies share the responsibilities of the transition to professional practice (House of Representatives Standing Committee on Education and Vocational Training, 2007) have, to date, largely been ignored. This paper reports on a trial project conducted at a university in south-east Queensland, Australia that addresses these shortfalls. The aim of the project is to facilitate and support the development of high quality teachers and teaching through an extended model of teacher preparation. The model comprises a 1+2 program of formal teacher preparation: a one-year teacher education course (the Graduate Diploma in Education), followed by a comprehensive two year program of workplace induction and ongoing professional learning tailored to meet graduate and employer needs. This paper reports on graduating students’ perceptions of their preparedness to teach as they transition from the Graduate Diploma in Education program to professional practice. The study concludes that innovative programs, including university-linked, ongoing professional learning support for teacher education graduates, may provide the way forward for enhancing the transition to practice for beginning teachers.