Malnutrition and pressure ulcer risk in adults in Australian health care facilities

Aims To determine the effect of nutritional status on the presence and severity of pressure ulcers in statewide? public healthcare facilities, in Queensland, Australia. Research Methods A multicentre, cross sectional audit of nutritional status of a convenience sample of subjects was carried out as part of a large audit of pressure ulcers in a sample of state based public healthcare facilities in 2002 and 2003. Dietitians in 20 hospitals and six residential aged care facilities conducted single day nutritional status audits of 2208 acute and 839 aged care subjects using the Subjective Global Assessment. The effect of nutritional status on the presence, highest stage and number of pressure ulcers was determined by logistic regression in a model controlling for age, gender, medical specialty and facility location. The potential clustering effect of facility was accounted for in the model using an analysis of correlated data approach. Results Subjects with malnutrition had an adjusted odds risk of 2.6 (95% CI 1.8-3.5, p<0.001) of having a pressure ulcer in acute facilities and 2.0 (95% CI 1.5-2.7, p<0.001) for residential aged care facilities. There was also increased odds risk of having a pressure ulcer, having a higher stage pressure ulcer and a higher number of pressure ulcers with increased severity of malnutrition. Conclusion Malnutrition was associated with at least twice the odds risk of having a pressure ulcer of in public healthcare facilities in Queensland. Action must be taken to identify, prevent and treat malnutrition, especially in patients at risk of pressure ulcer.

High impact training : achieving synergies between program management education and workplace practice

This paper addresses the challenges of transfer of training back to the workplace for programme and project managers who are being groomed for the leadership of large and complex projects. The paper draws on the experience of the development and delivery of Queensland University of Technology (QUT) education programs: an Executive Masters of Complex Project Management and a series of Continuing Professional Development (CPD) events for an Australian government agency, Defence Materiel Organisation (DMO). Drawing on notions of ‘far transfer’ (Laker 1990; Noe, 1986) and ‘transfer climate’ (Kozlowski & Salas, 1993; Yamnill & McLean, 2001), the paper describes the steps undertaken to achieve a design that ensures that programme and project leadership skills developed through these corporate education programs become successfully embedded back in the organisation. Further, the paper reports on a small qualitative study where the programme success was evaluated by the organisational sponsor, senior leaders and program participants. Nine interviews were conducted and analysed to identify the success of far transfer and transfer climate four months after the return of program participants from cohort 1 2008 to the workplace.

Customer satisfaction survey of the facilities provided by office building “X” in Surabaya

Many high-rise office buildings have been built in Surabaya. The investors have provided complimentary facilities to satisfy their tenants. However, not all given facilities has satisfied the tenants. The purpose of this study is to find out the level of tenant satisfaction in office “X” to the existing facilities and to suggest additional required facilities. Although office “X” is offered the highest rental rate and has known as a prestigious place in Surabaya, only location and public transport have satisfied the Indonesian tenants. Meanwhile, the multi National companies have not satisfied for any existing facilities. Additional ATM facilities and presentable cafeteria, improvement of service and the security system are required by tenants.

Creating and sustaining a basis for life-long learning in tertiary dancer training

This paper acknowledges the influences that a generation Y population brings to dance training methodologies and examines this impact in a tertiary context. Over the last 4 years, Queensland University of Technology has been modifying their curriculum for new students transitioning from the private dance studio into the prevocational university environment. An intensive training program was designed to empower the student creating effective entry points for common understandings in the learning and teaching of dance techniques with improved and accelerated learning outcomes. This paper shares these philosophies and practices in training for life-long learning that prepare the young dancer for longevity in the industry.

Research training and national innovation systems in Australia, Finland and the United States : a policy and systems study supported by 30 case studies of research students in the fields of geospatial science, wireless communication, biosciences, and materials science and engineering

Reforms to the national research and research training system by the Commonwealth Government of Australia sought to effectively connect research conducted in universities to Australia's national innovation system. Research training has a key role in ensuring an adequate supply of highly skilled people for the national innovation system. During their studies, research students produce and disseminate a massive amount of new knowledge. Prior to this study, there was no research that examined the contribution of research training to Australia's national innovation system despite the existence of policy initiatives aiming to enhance this contribution. Given Australia's below average (but improving) innovation performance compared to other OECD countries, the inclusion of Finland and the United States provided further insights into the key research question. This study examined three obvious ways that research training contributes to the national innovation systems in the three countries: the international mobility and migration of research students and graduates, knowledge production and distribution by research students, and the impact of research training as advanced human capital formation on economic growth. Findings have informed the concept of a research training culture of innovation that aims to enhance the contribution of research training to Australia's national innovation system. Key features include internationally competitive research and research training environments; research training programs that equip students with economically-relevant knowledge and the capabilities required by employers operating in knowledge-based economies; attractive research careers in different sectors; a national commitment to R&D as indicated by high levels of gross and business R&D expenditure; high private and social rates of return from research training; and the horizontal coordination of key organisations that create policy for, and/or invest in research training.

Training and development for transitional employment in mature-aged manual workers

The purpose of the current article was to explore perceptions of transitional employment and training and development amongst blue collar workers employed in technical, trade, operations or physical and labour-intensive occupations within the local government system.

Do research thesis examiners need training? : practitioner stories

We are thesis examiners within the Australian academic system who formed a “community of practice” to try to resolve some of the issues we were facing. Stories of examiners reflecting on and examining their own practice are a notable silence in the higher degree research literature. In this study we have adopted a storytelling inquiry method that involved telling our practitioner stories, firstly to each other and then to a wider audience through this paper. We then identified issues that we believe are relevant to other thesis examiners. We have also found that engaging in a “community of practice” is itself a valuable form of examiner professional development. Key Words: Thesis Examiner Training, Storytelling, and Practitioner Research

Comprehensive evaluation of driver gaze pattern using fuzzy rules for driver training

The over representation of novice drivers in crashes is alarming. Research indicates that one in five drivers’ crashes within their first year of driving. Driver training is one of the interventions aimed at decreasing the number of crashes that involve young drivers. Currently, there is a need to develop comprehensive driver evaluation system that benefits from the advances in Driver Assistance Systems. Since driving is dependent on fuzzy inputs from the driver (i.e. approximate distance calculation from the other vehicles, approximate assumption of the other vehicle speed), it is necessary that the evaluation system is based on criteria and rules that handles uncertain and fuzzy characteristics of the drive. This paper presents a system that evaluates the data stream acquired from multiple in-vehicle sensors (acquired from Driver Vehicle Environment-DVE) using fuzzy rules and classifies the driving manoeuvres (i.e. overtake, lane change and turn) as low risk or high risk. The fuzzy rules use parameters such as following distance, frequency of mirror checks, gaze depth and scan area, distance with respect to lanes and excessive acceleration or braking during the manoeuvre to assess risk. The fuzzy rules to estimate risk are designed after analysing the selected driving manoeuvres performed by driver trainers. This paper focuses mainly on the difference in gaze pattern for experienced and novice drivers during the selected manoeuvres. Using this system, trainers of novice drivers would be able to empirically evaluate and give feedback to the novice drivers regarding their driving behaviour.

Literacy models across nations : literacy and critical literacy in teacher training programs in India

The thrust towards constructivist learning and critical thinking in the National Curricular Framework (2005) of India implies shifts in pedagogical practices. In this context, drawing on grounded theory, focus group interviews were conducted with 40 preservice teachers to ascertain the contextual situation and the likely outcomes of applying critical literacy across the curriculum. Central themes that emerged in the discussion were: being teacher centred/ learner centred, and conformity/autonomy in teaching and learning. The paper argues that within the present Indian context, while there is scope for changes to pedagogy and learning styles, yet these must be adequately contextualised.

Development of a Systematic Approach to Assessing Quality within Australian Residential Aged Care Facilities: The Clinical Care Indicators Tool

Recent years have seen the introduction of formalised accreditation processes in both community and residential aged care, but these only partially address quality assessment within this sector. Residential aged care in Australia does not yet have a standardised system of resident assessment related to clinical, rather than administrative, outcomes. This paper describes the development of a quality assessment tool aimed at addressing this gap. Utilising previous research and the results of nominal groups with experts in the field, the 21-item Clinical Care Indicators (CCI) Tool for residential aged care was developed and trialled nationally. The CCI Tool was found to be simple to use and an effective means of collecting data on the state of resident health and care, with potential benefits for resident care planning and continuous quality improvement within facilities and organisations. The CCI Tool was further refined through a small intervention study to assess its utility as a quality improvement instrument and to investigate its relationship with resident quality of life. The current version covers 23 clinical indicators, takes about 30 minutes to complete and is viewed favourably by nursing staff who use it. Current work focuses on psychometric analysis and benchmarking, which should enable the CCI Tool to make a positive contribution to the measurement of quality in aged care in Australia.

A naturalistic inquiry of registered nurses' perspectives and expectations of psychodynamic therapeutic care in acute psychiatric inpatient facilities

Within contemporary inpatient mental health nursing practice, the psychodynamic model of care considered previously to be central to the nurse-patient relationship now seems a radical concept. It appears to exist only within primary care facilities and public health care practice settings. This naturalistic inquiry aimed to explicate mental health nurses' perspectives and expectations of providing psychodynamic therapeutic care in acute inpatient psychiatric facilities. Ten registered nurses working in acute inpatient mental health facilities were interviewed. Five themes emerged: a career for life, relating in a psychodynamic manner, swimming against the current, adopting a position of difference, and hopeful expectancy.

Birthing practices of traditional birth attendants in south Asia in the context of training programmes

Traditional Birth Attendants (TBA) training has been an important component of public health policy interventions to improve maternal and child health in developing countries since the 1970s. More recently, since the 1990s, the TBA training strategy has been increasingly seen as irrelevant, ineffective or, on the whole, a failure due to evidence that the maternal mortality rate (MMR) in developing countries had not reduced. Although, worldwide data show that, by choice or out of necessity, 47 percent of births in the developing world are assisted by TBAs and/or family members, funding for TBA training has been reduced and moved to providing skilled birth attendants for all births. Any shift in policy needs to be supported by appropriate evidence on TBA roles in providing maternal and infant health care service and effectiveness of the training programmes. This article reviews literature on the characteristics and role of TBAs in South Asia with an emphasis on India. The aim was to assess the contribution of TBAs in providing maternal and infant health care service at different stages of pregnancy and after-delivery and birthing practices adopted in home births. The review of role revealed that apart from TBAs, there are various other people in the community also involved in making decisions about the welfare and health of the birthing mother and new born baby. However, TBAs have changing, localised but nonetheless significant roles in delivery, postnatal and infant care in India. Certain traditional birthing practices such as bathing babies immediately after birth, not weighing babies after birth and not feeding with colostrum are adopted in home births as well as health institutions in India. There is therefore a thin precarious balance between the application of biomedical and traditional knowledge. Customary rituals and perceptions essentially affect practices in home and institutional births and hence training of TBAs need to be implemented in conjunction with community awareness programmes.