Access and Quality of Heart Failure Management Programs in Australia

Background/aim In response to the high burden of disease associated with chronic heart failure (CHF), in particular the high rates of hospital admissions, dedicated CHF management programs (CHF-MP) have been developed. Over the past five years there has been a rapid growth of CHF-MPs in Australia. Given the apparent mismatch between the demand for, and availability of CHF-MPs, this paper has been designed to discuss the accessibility to and quality of current CHF-MPs in Australia. Methods The data presented in this report has been combined from the research of the co-authors, in particular a review of the inequities in access to chronic heart failure which utilised geographical information systems (GIS) and the survey of heterogeneity in quality and service provision in Australian. Results Of the 62 CHF-MPs surveyed in this study 93% (58) centres had been located areas that are rated as Highly Accessible. This result indicated that most of the CHF-MPs have been located in capital cities or large regional cities. Six percent (4 CHF-MPs) had been located in Accessible areas which were country towns or cities. No CHF-MPs had been established outside of cities to service the estimated 72,000 individuals with CHF living in rural and remote areas. 16% of programs recruited NYHA Class I patients and of these 20% lacked confirmation (echocardiogram) of their diagnosis. Conclusion Overall, these data highlight the urgent need to provide equitable access to CHF-MP's. When establishing CHF-MPs consideration of current evidence based models to ensure quality in practice.

Measuring transit service reliability using data from web-based transit user survey : a case study at Brisbane, Australia

This paper reports an empirical study on measuring transit service reliability using the data from a Web-based passenger survey on a major transit corridor in Brisbane, Australia. After an introduction of transit service reliability measures, the paper presents the results from the case study including study area, data collection, and reliability measures obtained. This includes data exploration of boarding/arrival lateness, in-vehicle time variation, waiting time variation, and headway adherence. Impacts of peak-period effects and separate operation on service reliability are examined. Relationships between transit service characteristics and passenger waiting time are also discussed. A summary of key findings and an agenda of future research are offered in conclusions.

Collaborative destination branding : planning for tourism development through design in the Waterfall Way, NSW, Australia

This thesis develops, applies and analyses a collaborative design methodology for branding a tourism destination. The area between the Northern Tablelands and the Mid-North Coast of New South Wales, Australia, was used as a case study for this research. The study applies theoretical concepts of systems thinking and complexity to the real world, and tests the use of design as a social tool to engage multiple stakeholders in planning. In this research I acknowledge that places (and destinations) are socially constructed through people's interactions with their physical and social environments. This study explores a methodology that is explicit about the uncertainties of the destination’s system, and that helps to elicit knowledge and system trends. The collective design process used the creation of brand concepts, elements and strategies as instruments to directly engage stakeholders in the process of reflecting about their places and the issues related to tourism activity in the region. The methods applied included individual conversations and collaborative design sessions to elicit knowledge from local stakeholders. Concept maps were used to register and interpret information released throughout the process. An important aspect of the methodology was to bring together different stakeholder groups and translate the information into a common language that was understandable by all participants. This work helped release significant information as to what kind of tourism activity local stakeholders are prepared to receive and support. It also helped the emergence of a more unified regional identity. The outcomes delivered by the project (brand, communication material and strategies) were of high quality and in line with the desires and expectation of the local hosts. The process also reinforced local sense of pride, belonging and conservation. Furthermore, interaction between participants from different parts of the region triggered some self organising activity around the brand they created together. A major contribution of the present work is the articulation of an inclusive methodology to facilitate the involvement of locals into the decision-making process related to tourism planning. Of particular significance is the focus on the social construction of meaning in and through design, showing that design exercises can have significant social impact – not only on the final product, but also on the realities of the people involved in the creative process.

The Aboriginal voice and the left-leaning 'Australia' (Baz Luhrmann, 2008)

Arguing that Baz Luhrmann's "Australia" (2008) is a big-budget, non-independent film espousing a left-leaning political ideology in its non-racist representations of Aborigines on film, this paper suggests the addition of a 'fourth formation' to the 1984 Moore and Muecke model is warranted. According to their theorising, racist "first formation" films promote policies of assimilation whereas "second formation" films avoid overt political statements in favour of more acceptable multicultural liberalism. Moore and Muecke's seemingly ultimate "third formation films", however, blatantly foreground the director's leftist political dogma in a necessarily low budget, independent production. "Australia", on the other hand, is an advance on the third formation because its feminised Aboriginal voice is safely backed by a colossal production budget and indicates a transformation in public perceptions of Aboriginal issues. Furthermore, this paper argues that the use of low-cost post-production techniques such as voice-over narration by racially appropriate individuals and the use of diegetic song in Australia work to ensure the positive reception of the left-leaning message regarding the Stolen Generations. With these devices Luhrmann effectively counters the claims of right-wing denialists such as Andrew Bolt and Keith Windschuttle.

How do our 'quicks' generate pace? A cross sectional analysis of the Cricket Australia pace pathway

Technique and physical contributions to ball delivery speed in fast bowling have been popular research topics in sports science. However, a common limiting factor of this work is the level of expertise of participants and lack of within bowler investigations (Salter et al., 2007). The relationship between technique, anthropometry and ball speed has not been comprehensively investigated among elite fast bowlers. The purpose of this study was to examine the relationship between technique, anthropometric variables and ball speed using both within- and betweenbowler analyses in a cross section of the Cricket Australia high performance pace pathway.

A sustainable approach to community based rehabilitation in rural and remote Australia

This paper presents a summary of an extensive review of the health, disability and rehabilitation literature conducted for the purposes of informing the formulation of a sustainable approach to community based rehabilitation in rural and remote Australia. It begins with a review of definitions of disability and rehabilitation, which is followed by differentiating 'rehabilitation in the community' and 'community based rehabilitation'. Finally, a network of community based rehabilitation coalitions is proposed as a sustainable approach to community based rehabilitation in rural and remote Australia. Each coalition would have a community rehabilitation facilitator and community specific database of resources, as well as a register of local community rehabilitation assistants who can support the work of health professionals by providing rehabilitation interventions under the latter's direction. In this approach, rehabilitation is conceptualised as being about people's lives rather than only a series of interventions provided by health care professionals. As such, rehabilitation becomes everybody's business.

Let's take a closer look at teacher professionalism

Professional standards have been adopted by many Western countries, including Australia, as a mechanism for improving teacher quality and enhancing 'professionalism’. But what does the term 'professionalism' actually mean? This article briefly outlines different definitions of professionalism that have been advanced through many decades, and concludes with a 'new’ type of professionalism coined by the authors -'compliance professionalism’. They see this type of professionalism as a means for teachers to maintain a degree of professional autonomy, whilst at the same time allowing them to deal with ever increasing accountability regimes. The authors ask the question: What can principals do to make their teachers aware of 'professionalism’ in education?

Moderation and consistency of teacher judgement : teachers’ views

Major curriculum and assessment reforms in Australia have generated research interest in issues related to standards, teacher judgement and moderation. This article is based on one related inquiry of a large-scale Australian Research Council Linkage project conducted in Queensland. This qualitative study analysed interview data to identify teachers’ views on standards and moderation as a means to achieving consistency of teacher judgement. A complementary aspect of the research involved a blind review that was conducted to determine the degree of teacher consistency without the experience of moderation. Empirical evidence was gained that most teachers, of the total interviewed, articulated a positive attitude towards the use of standards in moderation and perceived that this process produces consistency in teachers’ judgements. Context was identified as an important influential factor in teachers’ judgements and it was concluded that teachers’ assessment beliefs, attitudes and practices impact on their perceptions of the value of moderation practice and the extent to which consistency can be achieved.

Assessing the resilience of potable water supplies in Southeast Queensland Australia

Historically, cities as urban forms have been critical to human development. In 1950, 30% of the world’s population lived in major cities. By the year 2000 this had increased to 47% with further expected growth to 50% by the end of 2007. Projections suggest that city-based densities will edge towards 60% of the global total by 2030. Such rapidly increasing urbanisation, in both developed and developing economies, challenges options for governance and planning, as well as crisis and disaster management. A common issue to the livability of cities as urban forms through time has been access to clean and reliable water supply. This is an issue that is particularly important in countries with arid ecosystems, such as Australia. This paper examines preliminary aspects, and theoretical basis, of a study into the resilience of the (potable) water supply system in Southeast Queensland (SEQ), an area with one of the most significant urban growth rates in Australia. The first stage will be to assess needs and requirements for gauging resilience characteristics of a generic water supply system, consisting of supply catchment, storage reservoir/s and treatment plant/s. The second stage will extend the analysis to examine the resilience of the SEQ water supply system incorporating specific characteristics of the SEQ water grid made increasingly vulnerable due to climate variability and projected impacts on rainfall characteristics and compounded by increasing demands due to population growth. Longer-term findings will inform decision making based on the application of the concept of resilience to designing and operating stand-alone and networked water supply infrastructure systems as well as its application to water resource systems more generally.

School system as axiological medium : the state's primary macro-proposing context and its expanding moral role in Australia

This paper analyses the Australian Values Education Program (VEP) within the framework of late-classical political economy. using analytical methods from systemic functional linguistics and critical discourse analysis, we demonstrate that the VEP is an unwitting restatement of the principles of ideology as developed by the likes of Destutt de Tracy and the Young Hegelians. We conclude that the sudden shock of globalisation and the post-national cultures this has entailed is in many ways similar to the shock of formal nationalism that emerged in the late-Seventeenth and early- Eighteenth centuries. The overall result of the VEP for the Australian school system is a massive procedural burden that is unlikely to produce the results at which the program is aimed.

Minimum labour standards enforcement in Australia : caught in the crossfire?

The complex transition from convict to free labour influenced state intervention in the employment relationship, and initiated the first minimum labour standards in Australia in 1828. Since then, two principal sets of tensions have affected the enforcement of such standards: tensions between government and employers, and tensions between the major political parties over industrial and economic issues. This article argues that these tensions have resulted in a sustained legacy affecting minimum labour standards’ enforcement in Australia. The article outlines broad historical developments and contexts of minimum labour standards’ enforcement in Australia since 1828, with more contemporary exploration focusing specifically on enforcement practices and policies in the Australian federal industrial relations jurisdiction. Current enforcement practices are an outcome of this volatile history, and past influences remain strong.

Super-orbital re-entry in Australia : laboratory measurement, simulation and flight observation

There are large uncertainties in the aerothermodynamic modelling of super-orbital re-entry which impact the design of spacecraft thermal protection systems (TPS). Aspects of the thermal environment of super-orbital re-entry flows can be simulated in the laboratory using arc- and plasma jet facilities and these devices are regularly used for TPS certification work [5]. Another laboratory device which is capable of simulating certain critical features of both the aero and thermal environment of super-orbital re-entry is the expansion tube, and three such facilities have been operating at the University of Queensland in recent years[10]. Despite some success, wind tunnel tests do not achieve full simulation, however, a virtually complete physical simulation of particular re-entry conditions can be obtained from dedicated flight testing, and the Apollo era FIRE II flight experiment [2] is the premier example which still forms an important benchmark for modern simulations. Dedicated super-orbital flight testing is generally considered too expensive today, and there is a reluctance to incorporate substantial instrumentation for aerothermal diagnostics into existing missions since it may compromise primary mission objectives. An alternative approach to on-board flight measurements, with demonstrated success particularly in the ‘Stardust’ sample return mission, is remote observation of spectral emissions from the capsule and shock layer [8]. JAXA’s ‘Hayabusa’ sample return capsule provides a recent super-orbital reentry example through which we illustrate contributions in three areas: (1) physical simulation of super-orbital re-entry conditions in the laboratory; (2) computational simulation of such flows; and (3) remote acquisition of optical emissions from a super-orbital re entry event.

Cosmetic surgery on children : professional and legal obligations in Australia

Public awareness and concern about cosmetic surgery on children is increasing. Nationally and internationally questions have been raised by the media and government bodies about the appropriateness of children undergoing cosmetic surgery. Considering the rates of cosmetic surgery in comparable Western societies, it seems likely that the number of physicians in Australia who will deal with a request for cosmetic surgery for a child will continue to increase. This is a sensitive issue and it is essential that physicians understand the professional and legal obligations that arise when cosmetic surgery is proposed for a child.

Reflections, successes and pitfalls of coordinating online discussion forums in a foreign language

The advent of e-learning has seen the adaptation and use of a plethora of educational techniques. Of these, online discussion forums have met with success and been used widely in both undergraduate and postgraduate education. The authors of this paper, having previously used online discussion forums in the postgraduate arena with success, adopted this approach for the design and subsequent delivery of a learning and teaching subject. This learning and teaching subject, however, was part of an international collaboration and designed for nurse academics in another country – Vietnam. With the nursing curriculum in Vietnam currently moving to adopt a competency based approach, two learning and teaching subjects were designed by an Australian university for Vietnamese nurse academics. Subject materials constituted a DVD which arrived by post and access to an online platform. Assessment for the subject included (but was not limited to) mandatory participation in online discussion with the other nurse academics enrolled in the subject. The purpose behind the online discussion was to generate discourse between the Vietnamese nurse academics located across Vietnam. Consequently the online discussions occurred in both Vietnamese and English; the Australian academic moderating the discussion did so in Australia with a Vietnamese translator. For the Australian University delivering this subject the difference between this and past online discussions were twofold: delivery was in a foreign language; and the teaching experience of the Vietnamese nurse teachers was mixed and frequently very limited. This paper will provide a discussion addressing the design of an online learning environment for foreign correspondents, the resources and translation required to maximise the success of the online discussion, the lessons learnt and consequent changes made, as well as the rationale of delivering complex content in a foreign language. While specifically addressing the first iteration of the first learning module designed, this paper will also address subsequent changes made for the second iteration of the first module and comment on their success. While a translator is clearly a key component of success, the elements of simplicity and clarity in hand with supportive online moderation must not be overlooked.

Understanding the role of knowledge in the practice of expert nephrology nurses in Australia

This paper, which is abstracted from a larger study into the acquisition and exercise of nephrology nursing expertise, aims to explore the role of knowledge in expert practice. Using grounded theory methodology, the study involved 17 registered nurses who were practicing in a metropolitan renal unit in New South Wales, Australia. Concurrent data collection and analysis was undertaken, incorporating participants' observations and interviews. Having extensive nephrology nursing knowledge was a striking characteristic of a nursing expert. Expert nurses clearly relied on and utilized extensive nephrology nursing knowledge to practice. Of importance for nursing, the results of this study indicate that domain-specific knowledge is a crucial feature of expert practice.