Dying in hospital: medical failure or natural outcomes?

The purpose of this study was to describe patterns of medical and nursing practice in the care of patients dying of oncological and hematological malignancies in the acute care setting in Australia. A tool validated in a similar American study was used to study the medical records of 100 consecutive patients who died of oncological or hematological malignancies before August 1999 at The Canberra Hospital in the Australian Capital Territory. The three major indicators of patterns of end-of-life care were documentation of Do Not Resuscitate (DNR) orders, evidence that the patient was considered dying, and the presence of a palliative care intention. Findings were that 88 patients were documented DNR, 63 patients' records suggested that the patient was dying, and 74 patients had evidence of a palliative care plan. Forty-six patients were documented DNR 2 days or less prior to death and, of these, 12 were documented the day of death. Similar patterns emerged for days between considered dying and death, and between palliative care goals and death. Sixty patients had active treatment in progress at the time of death. The late implementation of end-of-life management plans and the lack of consistency within these plans suggested that patients were subjected to medical interventions and investigations up to the time of death. Implications for palliative care teams include the need to educate health care staff and to plan and implement policy regarding the management of dying patients in the acute care setting. Although the health care system in Australia has cultural differences when compared to the American context, this research suggests that the treatment imperative to prolong life is similar to that found in American-based studies.

Changing learning to improve practice : hand hygiene education in Queensland medical schools

The aim of Queensland Health’s ‘Clean hands are life savers’ program is to change the culture and behaviour of healthcare workers related to hand hygiene. Hand hygiene is considered to be the most effective means of preventing pathogen cross-transmission and healthcare-associated infections. Most hospitals throughout Queensland as well as Australia now manage a hand hygiene program to increase the hand hygiene compliance of all healthcare workers. Reports taken from routine hand hygiene observations reveal that doctors are usually less compliant in their hand-washing practices than other healthcare worker groups. The Centre for Healthcare Related Infection Surveillance and Prevention (CHRISP) has attempted to have an impact on this challenging group through their Medical Leadership Initiative. With education as a core component of the program, efforts were made to ensure our future doctors were receiving information that aligned with Queensland Health standards during their formative years at medical school. CHRISP met with university instructors to understand what infection prevention education was currently included in the curriculum and support the introduction of new learning activities that specifically focused on hand hygiene. This prompted change to the existing curriculum and a range of interventions were employed with mixed success. Although met with challenges, methods to integrate more infection prevention teaching were found.

Early evidence for direct and indirect effects of the infant rotavirus vaccine program in Queensland

Objective: To assess the impact of introducing a publicly funded infant rotavirus vaccination program on disease notifications and on laboratory testing and results. Design and setting: Retrospective analysis of routinely collected data (rotavirus notifications [2006–2008] and laboratory rotavirus testing data from Queensland Health laboratories [2000–2008]) to monitor rotavirus trends before and after the introduction of a publicly funded infant rotavirus vaccination program in Queensland in July 2007. Main outcome measures: Age group-specific rotavirus notification trends; number of rotavirus tests performed and the proportion positive. Results: In the less than 2 years age group, rotavirus notifications declined by 53% (2007) and 65% (2008); the number of laboratory tests performed declined by 3% (2007) and 15% (2008); and the proportion of tests positive declined by 45% (2007) and 43% (2008) compared with data collected before introduction of the vaccination program. An indirect effect of infant vaccination was seen: notifications and the proportion of tests positive for rotavirus declined in older age groups as well. Conclusions: The publicly funded rotavirus vaccination program in Queensland is having an early impact, direct and indirect, on rotavirus disease as assessed using routinely collected data. Further observational studies are required to assess vaccine effectiveness. Parents and immunisation providers should ensure that all Australian children receive the recommended rotavirus vaccine doses in the required timeframe.

Graph-based concept weighting for medical information retrieval

This paper presents a graph-based method to weight medical concepts in documents for the purposes of information retrieval. Medical concepts are extracted from free-text documents using a state-of-the-art technique that maps n-grams to concepts from the SNOMED CT medical ontology. In our graph-based concept representation, concepts are vertices in a graph built from a document, edges represent associations between concepts. This representation naturally captures dependencies between concepts, an important requirement for interpreting medical text, and a feature lacking in bag-of-words representations. We apply existing graph-based term weighting methods to weight medical concepts. Using concepts rather than terms addresses vocabulary mismatch as well as encapsulates terms belonging to a single medical entity into a single concept. In addition, we further extend previous graph-based approaches by injecting domain knowledge that estimates the importance of a concept within the global medical domain. Retrieval experiments on the TREC Medical Records collection show our method outperforms both term and concept baselines. More generally, this work provides a means of integrating background knowledge contained in medical ontologies into data-driven information retrieval approaches.

Library research support in Queensland : a survey

University libraries worldwide are reconceptualising the ways in which they support the research agenda in their respective institutions. This paper is based on a survey completed by member libraries of the Queensland University Libraries Office of Cooperation (QUL OC), the findings of which may be informative for other university libraries. After briefly examining major emerging trends in research support, the paper discusses the results of the survey specifically focussing on support for researchers and the research agenda in their institutions. All responding libraries offer a high level of research support, however, eResearch support, in general, and research data management support, in particular, have the highest variance among the libraries, and signal possible areas for growth. Areas for follow-up, benchmarking and development are suggested.

Research data finder : an institutional metadata repository

QUT’s new metadata repository (data registry), Research Data Finder, has been designed to promote the visibility and discoverability of QUT research datasets. Funded by the Australian National Data Service (ANDS), it will provide a qualitative snapshot of research data outputs created or collected by members of the QUT research community that are available via open or mediated access. As a fully integrated metadata repository Research Data Finder aligns with institutional sources of truth, such as QUT’s research administrative system, ResearchMaster, as well as QUT’s Academic Profiles system to provide high quality data descriptions that increase awareness of, and access to, shareable research data. In addition, the repository and its workflows are designed to foster smoother data management practices, enhance opportunities for collaboration and research, promote cross-disciplinary research and maximize existing research datasets. The metadata schema used in Research Data Finder is the Registry Interchange Format - Collections and Services (RIF-CS), developed by ANDS in 2009. This comprehensive schema is potentially complex for researchers; unlike metadata for publications, which are often made publicly available with the official publication, metadata for datasets are not typically available and need to be created. Research Data Finder uses a hybrid self-deposit and mediated deposit system. In addition to automated ingests from ResearchMaster (research project information) and Academic Profiles system (researcher information), shareable data is identified at a number of key “trigger points” in the research cycle. These include: research grant proposals; ethics applications; Data Management Plans; Liaison Librarian data interviews; and thesis submissions. These ingested records can be supplemented with related metadata including links to related publications, such as those in QUT ePrints. Records deposited in Research Data Finder are harvested by ANDS and made available to a national and international audience via Research Data Australia, ANDS’ discovery service for Australian research data. Researcher and research group metadata records are also harvested by the National Library of Australia (NLA) and these records are then published in Trove (the NLA’s digital information portal). By contributing records to the national infrastructure, QUT data will become more visible. Within Australia and internationally, many funding bodies have already mandated the open access of publications produced from publicly funded research projects, such as those supported by the Australian Research Council (ARC), or the National Health and Medical Research Council (NHMRC). QUT will be well placed to respond to the rapidly evolving climate of research data management. This project is supported by the Australian National Data Service (ANDS). ANDS is supported by the Australian Government through the National Collaborative Research Infrastructure Strategy Program and the Education Investment Fund (EIF) Super Science Initiative.

Understanding the participatory library through a grounded theory study

Lankes and Silverstein (2006) introduced the “participatory library” and suggested that the nature and form of the library should be explored. In the last several years, some attempts have been made in order to develop contemporary library models that are often known as Library 2.0. However, little research has been based on empirical data and such models have had a strong focus on technical aspects but less focus on participation. The research presented in this paper fills this gap. A grounded theory approach was adopted for this study. Six librarians were involved in in-depth individual interviews. As a preliminary result, five main factors of the participatory library emerged including technological, human, educational, social-economic, and environmental. Five factors influencing the participation in libraries were also identified: finance, technology, education, awareness, and policy. The study’s findings provide a fresh perspective on contemporary library and create a basis for further studies on this area.

Phenomenography : opening a new territory for library and information science research

Phenomenography is a research approach devised to allow the investigation of varying ways in which people experience aspects of their world. Whilst growing attention is being paid to interpretative research in LIS, it is not always clear how the outcomes of such research can be used in practice. This article explores the potential contribution of phenomenography in advancing the application of phenomenological and hermeneutic frameworks to LIS theory, research and practice. In phenomenography we find a research toll which in revealing variation, uncovers everyday understandings of phenomena and provides outcomes which are readily applicable to professional practice. THe outcomes may be used in human computer interface design, enhancement, implementation and training, in the design and evaluation of services, and in education and training for both end users and information professionals. A proposed research territory for phenomenography in LIS includes investigating qualitative variation in the experienced meaning of: 1) information and its role in society 2) LIS concepts and principles 3) LIS processes and; 4) LIS elements.

Checking-in at the library : designing an ambient media system for social learning and collaboration opportunities

The knowledge economy of the 21st century requires skills such as creativity, critical thinking, problem solving, communication and collaboration (Partnership for 21st century skills, 2011) – skills that cannot easily be learnt from books, but rather through learning-by-doing and social interaction. Big ideas and disruptive innovation often result from collaboration between individuals from diverse backgrounds and areas of expertise. Public libraries, as facilitators of education and knowledge, have been actively seeking responses to such changing needs of the general public...

Using 3D visualisation to understand human articular cartilage deterioration

Understanding complex systems within the human body presents a unique challenge for medical engineers and health practitioners. One significant issue is the ability to communicate their research findings to audiences with limited medical knowledge or understanding of the behaviour and composition of such structures. Much of what is known about the human body is currently communicated through abstract representations which include raw data sets, hand drawn illustrations or cellular automata. The development of 3D Computer Graphics Animation has provided a new medium for communicating these abstract concepts to audiences in new ways. This paper presents an approach for the visualisation of human articular cartilage deterioration using 3D Computer Graphics Animation. The animated outcome of this research introduces the complex interior structure of human cartilage to audiences with limited medical engineering knowledge.