Chronic condition management and self-management in Aboriginal communities in South Australia : outcomes of a longitudinal study

OBJECTIVES: This paper describes the longitudinal component of a larger mixed methods study into the processes and outcomes of chronic condition management and self-management strategies implemented in three Aboriginal communities in South Australia. The study was designed to document the connection between the application of structured systems of care for Aboriginal people and their longer-term health status. METHODS: The study concentrated on three diverse Aboriginal communities in South Australia; the Port Lincoln Aboriginal Health Service, the Riverland community, and Nunkuwarrin Yunti Aboriginal Health Service in the Adelaide metropolitan area. Repeated-measure clinical data were collected for individual participants using a range of clinical indicators for diabetes (type 1 and 2) and related chronic conditions. Clinical data were analysed using random effects modelling techniques with changes in key clinical indicators being modelled at both the individual and group levels. RESULTS: Where care planning has been in place longer than in other sites overall improvements were noted in BMI, cholesterol (high density and low density lipids) and HbA1c. These results indicate that for Aboriginal patients with complex chronic conditions, participation in and adherence to structured care planning and self-management strategies can contribute to improved overall health status and health outcomes. CONCLUSIONS: The outcomes reported here represent an initial and important step in quantifying the health benefits that can accrue for Aboriginal people living with complex chronic conditions such as diabetes, heart disease and respiratory disease. The study highlights the benefits of developing long-term working relationships with Aboriginal communities as a basis for conducting effective collaborative health research programs.

Improving waste management in construction projects: an Australian study

Construction waste generation has been identified as one of the major issues in the construction industry due to its direct impacts on the environment as well as the efficiency of the construction industry. As the industry cannot continue to practice if the environmental resources on which it depends are depleted, the significance of waste management needs to be understood in order to encourage stakeholders to achieve related goals. Therefore, this research aims to determine effective approaches to eliminate and/or minimise waste generation in construction projects. Mixed methods were adopted by combining qualitative and quantitative research approaches. Interviews and a questionnaire survey were conducted as the primary data collection methods. The findings reveal twenty six critical solutions for waste management. Five factors of solutions for waste management were extracted from the exploratory factor analysis. These factors were: team building and supervision; strategic guidelines in waste management; proper design and documentation; innovation in waste management decisions; and lifecycle management. The evidence from this study suggests that both technologies and attitudinal approaches require improvement to eliminate/minimise waste generation in construction projects. Similarly, attention should be paid to being mindful of the environmental effects of waste generation and avoiding waste generation as early as possible in construction projects.

Recreational drug use within the employees of the mariculture and seafood industry in South Australia

A study of recreational drug use among workers in the Port Lincoln mariculture and seafood industries was conducted by self report questionnaire. High rates of cannabis and alcohol use were revealed during the shore based fish farming season. The occupational health and safety implications of these findings in one of Australia's most dangerous industries are significant. Further research could inform the development of industry specific harm minimisation policies.

Draft national targets for feral cat management: towards the effective control of feral cats in Australia – targets with teeth

Feral cats have been present in Australia since soon after European settlement. They are now numerous and pervasive across the continent, and occur on many islands. Although they have been recognised as a Key Threatening Process to Australian biodiversity under the EPBC Act since 1999, and there has been a Threat Abatement Plan for them in place since 2008, there has to date been little progress towards their effective management.

A prescription for resistance: management of Staphylococcal skin abscesses by general practitioners in Australia

Objectives: We investigated the management of staphylococcal abscesses (boils) by general practitioners (GPs) in the context of rising antibiotic resistance in community strains of Staphylococcus aureus.
Design, Setting, Participants: We analyzed patient-reported management of 66 cases of uncomplicated skin abscesses from the frequency matched methicillinresistant S. aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) Community- Onset Staphylococcus aureus Household Cohort (COSAHC) study (Melbourne, Australia, 2008–2012). Susceptibilities in all cases were known: 50/66 abscesses were caused by MRSA. In order to investigate GP-reported management of staphylococcal abscesses, we surveyed a random subset of GPs, from the COSAHC study (41), and of GPs (39) who used the same community-based pathology service (December 2011– May 2012). Main outcome measures: Patient outcomes, antibiotics prescribed, antibiotic resistance profiles of infecting strains, rates of incision and drainage (I&D), and attitudes to ordering microbiological cultures.
Results: MRSA was three times more likely to be cultured from an abscess than MSSA. Patient-reported management revealed 100% were prescribed antibiotics and only 60.6% had I&D. Of those 85% who remembered their prescription(s), 81% of MRSA cases and 23% of MSSA cases initially received inactive antibiotics. Repeat GP visits where antibiotics were changed occurred in 45 MRSA and 7 MSSA cases, although at least 33% of subsequent prescriptions were inactive for the MRSA infections. Patients treated with I&D and antibiotics did no better than those treated with only I&D, regardless of the antibiotic activity. In the GP surveys, 89% reported I&D, with or without antibiotics, to be their preferred management. Only 29.9% of GPs would routinely swab abscesses.

Innovation practice using pervasive mobile technology solutions to improve population health management: a pilot study of gestational diabetes patient care in Australia

Healthcare service delivery is moving forward from individual care to population health management, because of the fast growth of health records. However, to improve population health performance, it is necessary to leverage relevant data and information using new technology solutions, such as pervasive diabetes mobile technology solution of Inet International Inc., which offers the potential to facilitate patient empowerment with gestational diabetic care. Hence, this article examines the pilot study outcomes of a small clinical trial focusing on pregnant patients affected by gestational diabetes mellitus, in an Australian not for profit healthcare context. The aims include establishing proof of concept and also assessing the usability, acceptability, and functionality of this mobile solution and thereby generate hypotheses to be tested in a large-scale confirmatory clinical trial.

Australasian Society of Infectious Diseases updated guidelines for the management of Clostridium difficile infection in adults and children in Australia and New Zealand

The incidence of Clostridium difficile infection (CDI) continues to rise, whilst treatment remains problematic due to recurrent, refractory and potentially severe nature of disease. The treatment of C. difficile is a challenge for community and hospital-based clinicians. With the advent of an expanding therapeutic arsenal against C. difficile since the last published Australasian guidelines, an update on CDI treatment recommendations for Australasian clinicians was required. On behalf of the Australasian Society of Infectious Diseases, we present the updated guidelines for the management of CDI in adults and children.

Drivers for adopting reverse logistics in the construction industry : a qualitative study

Purpose - The purpose of this paper is to investigate and analyse the perceptions of South Australian construction practitioners on drivers affecting the implementation of reverse logistics (RL). In this context, RL is defined as the process of moving goods from their typical final destination for the purpose of capturing value or ensuring proper disposal.

Design/methodology/approach - Semi-structured interviews were conducted with eight practitioners to collect data and the interview transcripts were analysed using the NVivo (version 10) package. Cluster analysis was used to cross-validate the findings and provide an in-depth insight into the findings.

Findings - The findings indicate that most of the drivers identified in earlier research are relevant for the construction industry. In addition, the study identified some new drivers that are categorised as "targeted demands by an exclusive clientele". These drivers were found to be complementary to the economic, environmental and social drivers as previously conceptualised. In addition, a set of factors affecting the strength of drivers that had been overlooked in previous studies emanated from the interview analysis. These include the type of project and the attributes of clients, both of which strongly affect the drivers of RL implementation in construction.

Research limitations/implications - The major limitations are the relatively small size of the sample of interviewees and having interviewees from one geographic area with specific socio-economic characteristics.

Practical implications - The identified drivers and the clustering of RL themes could be used by practitioners as a "road map" for the development of appropriate solutions to successfully promote RL within the construction industry. Organisational energies could thus be channelled towards the drivers that need the most improvement.

Originality/value - The study contributes to this research sphere by employing cluster analysis to customise and contextualise the drivers that were previously identified. The study goes beyond the extant literature by discovering the prominent effects of these drivers on the impact of targeted demands by an exclusive clientele. This could be of great value in terms of creating avenues for future investigations on the topic.

Overcoming barriers to the reuse of construction waste material in Australia: a review of the literature

Although much has been written on how to improve the management of construction waste and increase the use of recycled materials, little progress has been made to address the reuse of construction waste. Yet there is a consensus in the literature that waste reuse practices have a decisive role to play in improving reduction of waste, and that institutional barriers are the most problematic obstacles to implementing identified reuse strategies. This paper examines the literature from the last 10 years on the issues facing different stakeholders around reuse of construction waste in Australia, and the causes and effects of the institutional barriers encountered. Key texts from before this period are also referenced. The findings reveal that institutional impediments are related to problems outside of the construction industry, such as social, economic and political barriers to change. A number of constraints are identified: lack of interest and demand from clients; attitudes towards reuse practices; and training all of which act as disincentives to a proactive and sustainable application of construction waste reuse strategies. Above all, it is argued that legislation should be better implemented to ensure that all states in Australia are required to implement strategies to reuse waste construction materials.

Preserving and interpreting the mining company office : landscape, space and technological change in the management of the copper industry

The purpose of this research is to examine the role of the mining company office in the management of the copper industry in Michigan’s Keweenaw Peninsula between 1901 and 1946. Two of the largest and most influential companies were examined – the Calumet & Hecla Mining Company and the Quincy Mining Company. Both companies operated for more than forty years under general managers who were arguably the most influential people in the management of each company. James MacNaughton, general manager at Calumet and Hecla, worked from 1901 through 1941; Charles Lawton, general manager at Quincy Mining Company, worked from 1905 through 1946. In this case, both of these managers were college-educated engineers and adopted scientific management techniques to operate their respective companies. This research focused on two main goals. The first goal of this project was to address the managerial changes in Michigan’s copper mining offices of the early twentieth century. This included the work of MacNaughton and Lawton, along with analysis of the office structures themselves and what changes occurred through time. The second goal of the project was to create a prototype virtual exhibit for use at the Quincy Mining Company office. A virtual exhibit will allow visitors the opportunity to visit the office virtually, experiencing the office as an office worker would have in the early twentieth century. To meet both goals, this project used various research materials, including archival sources, oral histories, and material culture to recreate the history of mining company management in the Copper Country.

B2C Digital business presence in the automobile industry

The purpose of this work is to investigate the digital online- and website- presence of the international automobile industry. The focus is on the business-to-consumer area to find out how digital communication is designed and if there are differences in the design dependent on the type of company or its cultural origin. The research is based on different quantitative as well as qualitative studies. After the selection and validation of the test sample, a qualitative content analysis for each corporate website in the test sample is conducted. Then, an extensive quantitative content analysis is applied. In a third step interviews with nine different experts from different sectors of the automobile company are carried out to validate the previous findings and obtain deeper insights. All of the findings are statistically analyzed and comprehensively evaluated.

Online presence of the international automobile industry: evaluation of the digital business representation in the business to consumer section of the international automobile industry

Tesis inédita presentada en la Universidad Europea de Madrid. Facultad de Ciencias Sociales. Programa de Doctorado en Economía y Empresa

The Australia-United States alliance and the management of elite opinion

This thesis firstly demonstrates that support for the current Australia-United States alliance at the elite level primarily derives from the desire to sustain western control over regional and international affairs and extend Australia’s influence abroad. Secondly, it demonstrates the role of the Australian American Leadership Dialogue in sustaining alliance orthodoxy.

Big, bold and blue: lessons from Australia's marine protected areas

The world’s oceans cover about 70% of our planet. To safeguard the delicate ecological and environmental functions of the oceans and their remarkable biodiversity, networks of marine protected areas are being created. In some of these areas, human activity is restricted to non-exploitative activities and in others it is managed in a sustainable way. Australia is at the forefront of marine conservation, with one of the largest systems of marine protected areas in the world.Big, Bold and Blue: Lessons from Australia’s Marine Protected Areas captures Australia’s experience, sharing important lessons from the Great Barrier Reef and many other extraordinary marine protected areas. It presents real-world examples, leading academic research, perspectives on government policy, and information from indigenous sea country management, non-governmental organisations, and commercial and recreational fishing sectors. The lessons learnt during the rapid expansion of Australia’s marine protected areas, both positive and negative, will aid and advise other nations in their own marine conservation efforts.The book is ideal reading for marine planners and managers across the globe; academic institutions where research on marine environments occur; government agencies across the world implementing and creating policy around MPA development; non-government organisations involved in lobbying for MPA expansion; and fisheries agencies and industry stakeholders.

Impacts and management of feral cats Felis catus in Australia

Feral cats are among the most damaging invasive species worldwide, and are implicated in many extinctions, especially in Australia, New Zealand and other islands. Understanding and reducing their impacts is a global conservation priority. We review knowledge about the impacts and management of feral cats in Australia, and identify priorities for research and management. In Australia, the most well understood and significant impact of feral cats is predation on threatened mammals. Other impacts include predation on other vertebrates, resource competition, and disease transmission, but knowledge of these impacts remains limited. Lethal control is the most common form of management, particularly via specifically designed poison baits. Non-lethal techniques include the management of fire, grazing, food, and trophic cascades. Managing interactions between these processes is key to success. Given limitations on the efficacy of feral cat management, conservation of threatened mammals has required the establishment of insurance populations on predator-free islands and in fenced mainland enclosures. Research and management priorities are to: prevent feral cats from driving threatened species to extinction; assess the efficacy of new management tools; trial options for control via ecosystem management; and increase the potential for native fauna to coexist with feral cats.