A survey of the Queensland healthcare workforce : attitudes towards dementia care and training

Background Positive attitudes of healthcare staff towards people with dementia promote higher quality care, although little is known about important factors that underlie positive attitudes. Key aims of this project were to explore the relationships between staff attitudes towards dementia, self-confidence in caring for people with dementia, experience and dementia education and training. Method A brief online survey was developed and widely distributed to registered nurses and allied health professionals working in Queensland in 2012. Regression analyses were performed to identify important predictors of self-confidence in caring for people with dementia and positive attitudes towards people with dementia. Results Five hundred and twenty-four surveys were completed by respondents working in a range of care settings across Queensland. Respondents were predominantly female (94.1%), and most were registered nurses (60%), aged between 41 and 60 years (65.6%). Around 40% regularly worked with people with dementia and high levels of self-confidence in caring for this population and positive attitudes towards people with dementia were reported. The majority of respondents (67%) had participated in a dementia education/training activity in the past 12 months. More experience working with people with dementia predicted greater self-confidence while recent participation in a dementia education/training and higher self-confidence in caring for a person with dementia significantly predicted more positive attitudes towards people with dementia. Conclusion These results confirm the importance of self-confidence and dementia education in fostering positive attitudes and care practices towards people with dementia. Our results also indicate that the demand for ongoing dementia education is high amongst health care workers and it is recommended that regular dementia education/ training be provided and promoted for all healthcare personnel who work with people with dementia.

A data mining approach to improve the automated quality of data

This thesis describes the development of a robust and novel prototype to address the data quality problems that relate to the dimension of outlier data. It thoroughly investigates the associated problems with regards to detecting, assessing and determining the severity of the problem of outlier data; and proposes granule-mining based alternative techniques to significantly improve the effectiveness of mining and assessing outlier data.

Reconciling folksonomic tagging with taxa for bioacoustic annotations

Acoustic sensors are increasingly used to monitor biodiversity. They can remain deployed in the environment for extended periods to passively and objectively record the sounds of the environment. The collected acoustic data must be analyzed to identify the presence of the sounds made by fauna in order to understand biodiversity. Citizen scientists play an important role in analyzing this data by annotating calls and identifying species. This paper presents our research into bioacoustic annotation techniques. It describes our work in defining a process for managing, creating, and using tags that are applied to our annotations. This paper includes a detailed description of our methodology for correcting and then linking our folksonomic tags to taxonomic data sources. Providing tools and processes for maintaining species naming consistency is critical to the success of a project designed to generate scientific data. We demonstrate that cleaning the folksonomic data and providing links to external taxonomic authorities enhances the scientific utility of the tagging efforts of citizen scientists.

The power of hands-on exercises in SCADA cyber security education

For decades Supervisory Control and Data Acquisition (SCADA) and Industrial Control Systems (ICS) have used computers to monitor and control physical processes in many critical industries, including electricity generation, gas pipelines, water distribution, waste treatment, communications and transportation. Increasingly these systems are interconnected with corporate networks via the Internet, making them vulnerable and exposed to the same risks as those experiencing cyber-attacks on a conventional network. Very often SCADA networks services are viewed as a specialty subject, more relevant to engineers than standard IT personnel. Educators from two Australian universities have recognised these cultural issues and highlighted the gap between specialists with SCADA systems engineering skills and the specialists in network security with IT background. This paper describes a learning approach designed to help students to bridge this gap, gain theoretical knowledge of SCADA systems' vulnerabilities to cyber-attacks via experiential learning and acquire practical skills through actively participating in hands-on exercises.

A comparison of children's needs models in the Australian and Chinese context

The diverse needs of children have been drawing global attention from both academic and practitioner communities. Based on semi-structured interviews with 23 kin caregivers and five school personnel in the Shijiapu Town of Jilin Province, China, this paper presents a needs model for rural school-age children left behind by their migrant parents. This Chinese model is compared to the needs identification mechanism developed by the Australian Research Alliance for Children and youth. The paper outlines the common needs of children in different contexts, and also highlights the needs that are not explicit in the Australian Research Alliance for Children and Youth framework, such as empowerment and agency or perhaps given insufficient weight, such as education. In discussing relationships among different needs, aspects that are missing in the framework it is argued that culture should be more explicitly recognised when defining need.

Compliance with standard precautions and occupational exposure reporting among operating room nurses in Australia

Occupational exposures of healthcare workers tend to occur because of inconsistent compliance with standard precautions. Also, incidence of occupational exposure is underreported among operating room personnel. The purpose of this project was to develop national estimates for compliance with standard precautions and occupational exposure reporting practices among operating room nurses in Australia. Data was obtained utilizing a 96-item self-report survey. The Standard Precautions and Occupational Exposure Reporting survey was distributed anonymously to 500 members of the Australian College of Operating Room Nurses. The Health Belief Model was the theoretical framework used to guide the analysis of data. Data was analysed to examine relationships between specific constructs of the Health Belief Model to identify factors that might influence the operating room nurse to undertake particular health behaviours to comply with standard precautions and occupational exposure reporting. Results of the study revealed compliance rates of 55.6% with double gloving, 59.1% with announcing sharps transfers, 71.9% with using a hands-free sharps pass technique, 81.9% with no needle recapping and 92.0% with adequate eye protection. Although 31.6% of respondents indicated receiving an occupational exposure in the past 12 months, only 82.6% of them reported their exposures. The results of this study provide national estimates of compliance with standard precautions and occupational exposure reporting among operating room nurses in Australia. These estimates can now be used as support for the development and implementation of measures to improve practices in order to reduce occupational exposures and, ultimately, disease transmission rates among this high-risk group.

Scrub typhus in mainland China, 2006–2012 : the need for targeted public health interventions

Scrub typhus is a vector-borne disease carried by the chigger mite. The aetiological agent is the rickettsia Orientia tsutsugamushi, which is endemic to several countries in the Asia-Pacific region, including China [1]. It is also a travel-associated disease [2] and of great importance among military personnel [3], [4]. During the Second World War, scrub typhus was associated with a higher case fatality ratio than any other infectious disease in the China-Burma-India theatre of operations 1,3. Clinical presentation in patients varies from asymptomatic to life-threatening disease [5], including acute hearing loss and multiple organ failure [6], [7]. To date, there is still no effective and reliable human vaccine against scrub typhus and no point-of-care diagnostics available [1].

A Guide to Applying Road Safety within a Workplace : A Bilateral Approach to Organisational Road Safety in Australia and New Zealand

Corporate and organisational fleet and road safety is of strong interest to government and government agencies in Australia and New Zealand. It has been identified that there is great opportunity to engage and assist organisations and corporations in the delivery of road safety and road safety measures to achieve nationally significant road related trauma reductions. This guide has therefore been developed through public sector funding for use by any workplace within Australia and New Zealand. Significant road safety benefits can be achieved by road safety government agencies (Australia and New Zealand) that engage with private and public sectors at their workplaces to address work related road safety issues. It has also been noted that organisational road safety advancement creates effective and sustainable outcomes, safer places of employment, and safer communities. This can be achieved without totally relying upon traditional and often lengthy processes such as further public legislation and/ or community attitudinal and behavioural change programs. Currently, there is little in the way of robust guides or support for those organisations that are wishing to adopt road safety within their places of employment, supply chain and/ or community. Due to this identified gap in available resource and support, it has been recommended that a practical organisational road safety guide be produced; hence the development of this guide. A guide, or supporting documentation, that bridges the gap between government and road safety research knowledge, internationally endorsed road safety methodology, and assists industry as the end user. To achieve this, the guide is designed to be non-specific to any industry sector and usable for small or large organisations, public or private, and engaging for senior executives and the personnel on the ground responsible for its implementation. Therefore, this guide is based on methodology and principles so that it can be applicable in a scalable way to the greatest number of public and private organisations while providing enough detail and ‘how to’ advice to enable organisations to generate their own solutions to road safety issues.

An evidence-based brochure to educate contact lens wearers about safe contact lens wear

Contact lenses are a successful and popular means to correct refractive error and are worn by just under 700,000 Australians1 and approximately 125 million people worldwide. The most serious complication of contact lens wear is microbial keratitis, a potentially sight-threatening corneal infection most often caused by bacteria. Gram-negative bacteria, in particular pseudomonas species, account for the majority of severe bacterial infections. Pathogens such as fungi or amoebae, which feature less often, are associated with significant morbidity. These unusual pathogens have come into the spotlight in recent times with an apparent association with specific lens cleaning solutions...

Long-term azithromycin for Indigenous children with non-cystic-fibrosis bronchiectasis or chronic suppurative lung disease (Bronchiectasis Intervention Study) : a multicentre, double-blind, randomised controlled trial

Background Indigenous children in high-income countries have a heavy burden of bronchiectasis unrelated to cystic fibrosis. We aimed to establish whether long-term azithromycin reduced pulmonary exacerbations in Indigenous children with non-cystic-fibrosis bronchiectasis or chronic suppurative lung disease. Methods Between Nov 12, 2008, and Dec 23, 2010, we enrolled Indigenous Australian, Maori, and Pacific Island children aged 1—8 years with either bronchiectasis or chronic suppurative lung disease into a multicentre, double-blind, randomised, parallel-group, placebo-controlled trial. Eligible children had had at least one pulmonary exacerbation in the previous 12 months. Children were randomised (1:1 ratio, by computer-generated sequence with permuted block design, stratified by study site and exacerbation frequency [1—2 vs ≥3 episodes in the preceding 12 months]) to receive either azithromycin (30 mg/kg) or placebo once a week for up to 24 months. Allocation concealment was achieved by double-sealed, opaque envelopes; participants, caregivers, and study personnel were masked to assignment until after data analysis. The primary outcome was exacerbation (respiratory episodes treated with antibiotics) rate. Analysis of the primary endpoint was by intention to treat. At enrolment and at their final clinic visits, children had deep nasal swabs collected, which we analysed for antibiotic-resistant bacteria. This study is registered with the Australian New Zealand Clinical Trials Registry; ACTRN12610000383066. Findings 45 children were assigned to azithromycin and 44 to placebo. The study was stopped early for feasibility reasons on Dec 31, 2011, thus children received the intervention for 12—24 months. The mean treatment duration was 20·7 months (SD 5·7), with a total of 902 child-months in the azithromycin group and 875 child-months in the placebo group. Compared with the placebo group, children receiving azithromycin had significantly lower exacerbation rates (incidence rate ratio 0·50; 95% CI 0·35—0·71; p<0·0001). However, children in the azithromycin group developed significantly higher carriage of azithromycin-resistant bacteria (19 of 41, 46%) than those receiving placebo (four of 37, 11%; p=0·002). The most common adverse events were non-pulmonary infections (71 of 112 events in the azithromycin group vs 132 of 209 events in the placebo group) and bronchiectasis-related events (episodes or investigations; 22 of 112 events in the azithromycin group vs 48 of 209 events in the placebo group); however, study drugs were well tolerated with no serious adverse events being attributed to the intervention. Interpretation Once-weekly azithromycin for up to 24 months decreased pulmonary exacerbations in Indigenous children with non-cystic-fibrosis bronchiectasis or chronic suppurative lung disease. However, this strategy was also accompanied by increased carriage of azithromycin-resistant bacteria, the clinical consequences of which are uncertain, and will need careful monitoring and further study.

Heat strain and hydration status of surface mine blast crew workers

Objective Dehydration and symptoms of heat illness are common among the surface mining workforce. This investigation aimed to determine whether heat strain and hydration status exceeded recommended limits. Methods Fifteen blast crew personnel operating in the tropics were monitored across a 12-hour shift. Heart rate, core body temperature, and urine-specific gravity were continuously recorded. Participants self-reported fluid consumption and completed a heat illness symptom inventory. Results Core body temperature averaged 37.46 +/- 0.13[degrees]C, with the group maximum 37.98 +/- 0.19[degrees]C. Mean urine-specific gravity was 1.024 +/- 0.007, with 78.6% of samples 1.020 or more. Seventy-three percent of workers reported at least one symptom of heat illness during the shift. Conclusions Core body temperature remained within the recommended limits; however, more than 80% of workers were dehydrated before commencing the shift, and tended to remain so for the duration.

A multidimensional model of client success when engaging external consultants

Too often the relationship between client and external consultants is perceived as one of protagonist versus antogonist. Stories on dramatic, failed consultancies abound, as do related anecdotal quips. A contributing factor to many "apparently" failed consultancies is a poor appreciation by both the client and consultant of the client's true goals for the project and how to assess progress toward these goals. This paper presents and analyses a measurement model for assessing client success when engaging an external consultant. Three main areas of assessment are identified: (1) the consultant;s recommendations, (2) client learning, and (3) consultant performance. Engagement success is emperically measured along these dimensions through a series of case studies and a subsequent survey of clients and consultants involved in 85 computer-based information system selection projects. Validation fo the model constructs suggests the existence of six distinct and individually important dimensions of engagement success. both clients and consultants are encouraged to attend to these dimensions in pre-engagement proposal and selection processes, and post-engagement evaluation of outcomes.

Noise levels in a General Surgical Ward : a descriptive study

Aims and objectives.  This study was undertaken to measure and analyse levels of acoustic noise in a General Surgical Ward. Method.  Measurements were undertaken using the Norsonic 116 sound level meter (SLM) recording noise levels in the internationally agreed ‘A’ weighted scale. Noise level data and observational data as to the number of staff present were obtained and recorded at 5-min intervals over three consecutive days. Results.  Results of noise level analysis indicated that mean noise level within this clinical area was 42.28 dB with acute spikes reaching 70 dB(A). The lowest noise level attained was that of 36 dB(A) during the period midnight to 7 a.m. Non-parametric testing, using Spearman's Rho (two-tailed), found a positive relationship between the number of staff present and the level of noise recorded, indicating that the presence of hospital personnel strongly influences the level of noise within this area. Relevance to clinical practice.  Whilst the results of this may seem self-evident in many respects the problems of excessive noise production and the exposure to it for patients, hospital personnel and relatives alike continues unabated. What must be of concern is the psychophysiological effects excessive noise exposure has on individuals, for example, decreased wound healing, sleep deprivation and cardiovascular stimulation.

What knowledge do ICU nurses have with regard to the effects of noise exposure in the Intensive Care Unit?

This small-scale study was undertaken to assess what knowledge nursing staff from a General Intensive Care Unit held with regard to noise exposure. To assess knowledge a self-administered multiple-choice questionnaire was used. Rigorous peer-review insured content validity. This study produced poor results in terms of the knowledge nurses held with regard to noise related issues in particular the psychophysiological effects and current legislation concerning its safe exposure. Non-parametric testing, using Kruskal–Wallis found no significant difference between nursing grades, however, descriptive analysis demonstrated that the staff nurse grade (D and E) performed better overall. Whilst the results of this study may seem self-evident in some respects, it is the problems of exposure to excessive noise levels for both patients and hospital personnel, which are clearly not understood. The effects noise exposure has on individuals for example decreased wound healing; sleep deprivation and cardiovascular stimulation must be of concern especially in terms of patient care but more so for nursing staff especially the effects noise levels can have on cognitive task performance.