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1
Angus, Jocelyn. "Leadership: a central tenet for postgraduate dementia services curricula development in Australia." International Psychogeriatrics 21, S1 (April 2009): S16—S24. http://dx.doi.org/10.1017/s1041610209008825.
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ABSTRACTBackground: In the next decades of the twenty-first century, the global aging of populations will challenge every nation's ability to provide leadership by qualified health professionals to reshape and improve health care delivery systems. The challenge for educators is to design and deliver courses that will give students the knowledge and skills they need to fill that leadership role confidently in dementia care services. This paper explores the ways in which a curriculum can develop graduates who are ready to become leaders in shaping their industry.Method: The Master of Health Science – Aged Services (MHSAS) program at Victoria University, Melbourne, Australia is applied as a case study to describe the process by which the concept of leadership is applied as the key driver in curriculum development, teaching practices and learning outcomes.Results: Evaluation instruments employed in a variety of purposes including teaching, curriculum planning and unit appraisal are discussed. Challenges for the future are proposed including the need for postgraduate programs in dementia to seek stronger national and international benchmarks and associations with other educational institutions to promote leadership and a vision of what is possible and desirable in dementia care provision.Conclusions: In the twenty-first century, effective service provision in the aged health care sector will require postgraduate curricula that equip students for dementia care leadership. The MHSAS program provides an established template for such curricula.
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Land, Nicole, Catherine Hamm, Sherri-Lynn Yazbeck, Miriam Brown, Ildikó Danis, and Narda Nelson. "Doing pedagogical intentions with Facetiming Common Worlds (and Donna Haraway)." Global Studies of Childhood 10, no. 2 (January 27, 2020): 131–44. http://dx.doi.org/10.1177/2043610618817318.
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Working with stories of children’s relationships with place and technologies from an early childhood education pedagogical inquiry research project in Melbourne, Australia and Victoria, Canada, this article takes up the concept of “pedagogical intentions” to consider how educators and researchers might cultivate intentional teaching practices relevant to the complex worlds we inherit with children. We think with a common worlds pedagogies approach to extend conceptualizations of intentional teaching held in dominant Euro-Western early learning frameworks in Melbourne and Victoria. After situating our understanding of pedagogical intentionality as an ongoing, purposeful, answerable practice of shaping and caring with everyday pedagogical relationships, we share three stories of how we activate our Donna Haraway–inspired intentions with children. By questioning how our pedagogical intentions inform our work, we assert that sharing and putting at risk our intentions is a necessary practice for thinking collectively with children, more-than-human others, and technologies within early childhood education.
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Stevenson, Brian. "Collaborative practice re-energises bioscience teaching in schools." Microbiology Australia 31, no. 1 (2010): 27. http://dx.doi.org/10.1071/ma10027.
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This year marks the first decade of operations for the Gene Technology Access Centre (GTAC). The decade has seen a grassroots initiative by a small group of eminent research scientists and dedicated personnel from the University High School in Melbourne grow into a specialist education centre in cell and molecular biology that attracts over 6000 students and their teachers each year. GTAC has not only refocused student and teacher attention on the interdisciplinary nature of contemporary biology, but has also highlighted how a ?centre model for learning?, based upon collaboration and partnerships, can exist within ?the school system? and meet the needs of students and teachers from across Victoria and beyond.
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Kolnhofer-Derecskei, Anita. "How did the COVID-19 restrictions impact higher education in Victoria?" Multidiszciplináris kihívások, sokszínű válaszok, no. 1 (August 31, 2022): 50–72. http://dx.doi.org/10.33565/mksv.2022.01.03.
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This paper aims to observe how the Australian COVID-19 restrictions influenced higher education, teachers’ and students’ lives. Before the pandemic, the higher education sector was the largest serviced based sector in Australia and overly depended on international students’ fee income. The academic year of 2020 started as usual with 141703 higher education enrolments of overseas students, mainly students from Asia. However, they did not arrive due to the strict border closure. Travel restrictions were put in place from China from 1 February 2020, later from other countries worldwide. That significantly affected international students' travel from Asia directly before the start of the new academic year. Consequently, many institutions have transitioned from campus-based courses to online delivery. Besides, numerous academic lecturers and professional staff have been invited to the expression of interest in a voluntary and, of course, involuntary redundancy program. Most vacant positions have been frozen, and various saving programs have been implied. Owing to the toughest rules and strictest restrictions, Australian borders remained closed for over 600 days. Melbourne was under six lockdowns totalling 265 days since March 2020, which resulted in the author’s experience of three semester-long remote teaching at one of the biggest and most prominent universities in Melbourne without any personal contact with international students. The author lived and worked in Melbourne during the COVID-19 era, so this study is based on her perspectives and experiences extended with a wide empirical evaluation of secondary data about the Australian academic sector between 2020 and 2021.
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Daniel, Jeffrey, James Chamberlain, and David Castle. "The Pharmacological Management of Behavioural Disturbance in Psychosis: a Naturalistic Study." Australasian Psychiatry 15, no. 5 (October 2007): 380–84. http://dx.doi.org/10.1080/10398560701435754.
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Objective: The aim of the study was to compare the efficacy of atypical and typical anti-psychotics in treating behavioural disturbance in people with psychotic disorders, in a naturalistic setting. Method: This was a prospective naturalistic study of 303 incidents of behavioural disturbance at Royal Melbourne Hospital, Melbourne, Victoria, Australia. Results: There was no significant difference between atypicals and typicals on two efficacy measures and some evidence on a third measure, that typicals are more effective. Conclusions: In the pharmacological treatment of behavioural disturbance in psychosis, typical and atypical anti-psychotics have largely comparable efficacy.
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Rae, Ian D. "David Orme Masson, the Periodic Classification of the Elements and His ‘Flap’ Model of the Periodic Table." Historical Records of Australian Science 24, no. 1 (2013): 40. http://dx.doi.org/10.1071/hr12018.
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In the early 1890s, David Orme Masson, Professor of Chemistry at the University of Melbourne, invented a new way to display the periodic table of the elements, in which the transition elements were arranged on a flap that projected from the plane containing the main group elements. He shared the idea with his mentor, Sir William Ramsay, at University College London, who published a similar model in his 1896 book. The ?flap' arrangement was an outcome of Masson's research interest in the periodic classification of the elements, to which he also made contributions in the 1890s about the placement of hydrogen and suggested to Ramsay that a new main group was needed to accommodate the rare gases such as helium and argon then being discovered in London. Although it was not widely adopted elsewhere, Masson's ?flap' model was a research and a teaching tool that was used at the University of Melbourne and in school chemistry teaching in Victoria for over half a century.
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Jackson, Terri, and Petia Sevil. "Problems in counting and paying for multidisciplinary outpatient clinics." Australian Health Review 20, no. 3 (1997): 38. http://dx.doi.org/10.1071/ah970038.
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Policy-makers have always found it problematic to formulate fair and consistentcounting rules for public hospital outpatient activities. In the context of output-based funding, such rules have consequences which can affect patient care. This paper reviews the rationale for organising multidisciplinary clinics and reports on a series of focus groups convened in four Melbourne teaching hospitals to consider funding policy for such clinics. It discusses issues of targeting outpatient services, along with implications for payment policy. It evaluates counting rules in terms of intended andunintended consequences in the context of Victoria?s introduction of output-basedfunding for outpatient services.
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Cohn, Helen M. "Watch Dog over the Herbarium: Alfred Ewart, Victorian Government Botanist 1906 - 1921." Historical Records of Australian Science 16, no. 2 (2005): 139. http://dx.doi.org/10.1071/hr05009.
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Alfred Ewart was Government Botanist in the service of the Victorian Government from February 1906 to February 1921. He was concurrently foundation Professor of Botany at the University of Melbourne, both positions being part-time. As Government Botanist he was in charge of the National Herbarium of Victoria, which had fallen into a slump after the death of the first Government Botanist, Ferdinand von Mueller, in 1896. Ewart was determined to restore the Herbarium to its former position as a leading centre of research on the Victorian and indeed the Australian flora. In doing so he enlisted the aid of the many capable botanists who were members of the Field Naturalists' Club of Victoria. The Herbarium being in the Department of Agriculture, Ewart had duties in relation to the business of that Department. These had mainly to do with weeds, impure seeds and providing advice to departmental officers. Of particular importance was his taxonomic work as Government Botanist. He published a series of papers and books on the flora of Victoria and the Northern Territory, and engaged in debates with colleagues both interstate and overseas. Ewart ceased to be Government Botanist when the professorship was made a full-time appointment in response to increased teaching loads.
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Leshinsky, Rebecca. "Touching on transparency in city local law making." International Journal of Law in the Built Environment 8, no. 3 (October 10, 2016): 194–209. http://dx.doi.org/10.1108/ijlbe-01-2016-0001.
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Purpose The purpose for this paper is to share jurisdictional knowledge on local law-making theory and praxis, an area of law not well represented in the literature despite its involvement in day-to-day life. Design/methodology/approach The paper not only shares knowledge about the local law-making process in Melbourne, Australia, but also explores attitudes to local law-making gathered through semi-structured interviews from a sample of relevant stakeholders. Findings The paper reports on findings from a study undertaken in Melbourne, Australia. Stakeholder perceptions and attitudes were canvassed regarding local law-making in the areas of land use planning and waste management. Overall, stakeholders were satisfied that Melbourne is a robust jurisdiction offering a fair and transparent local law-making system, but they see scope for more public participation. Research limitations/implications The findings suggest that even though the state of Victoria offers a fair and transparent system of local law-making, there is still significant scope for more meaningful involvement from the community, as well as space for more effective enforcement of local laws. The stage is set for greater cross-jurisdictional reciprocal learning about local law-making between cities. Originality/value This paper offers meaningful and utilitarian insight for policy and law makers, academics and built environment professionals from relevant stakeholders on the operation and transparency of local law-making.
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Markiewicz, Anne. "The pre-hearing convenor: A skilled practitioner chairing conferences in the Children's Court of Victoria." Children Australia 21, no. 4 (1996): 22–28. http://dx.doi.org/10.1017/s1035077200007276.
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An evaluation of pre-hearing conferences in the Children's Court of Victoria was carried out during 1994 by five members of staff from the School of Social Work at the University of Melbourne. An interesting theme which emerged from this evaluation is the role of the convenor as pivotal to the process of the pre-hearing conference. The convenor has emerged as a critical figure in the success of the mediation process, and the knowledge, skills, and values they are equipped with are seen as essential to their effective operation. This article describes the role of convenors and the many responsibilities they must juggle in fulfilling their role, and the characteristics which make for an effective and successful conference. As conferences become a more frequent method of resolving conflict between individuals, families and society, it is hoped that the principles which emerge from this article will be applied to other conference proceedings. It is clear that we are moving away from conventional adversarial methods, to mediative and conciliative modes, and in doing so we need to become clear about the characteristics which are required for such processes. This is one exploratory study of a pilot project in Victoria which should be of interest to other conferencing and mediation mechanisms.
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Tangalakis, Kathy, Kate Kelly, Natalie KonYu, and Dianne Hall. "The impact of teaching from home during the covid-19 pandemic on the student evaluations of female academics." Journal of University Teaching and Learning Practice 19, no. 1 (March 8, 2022): 160–75. http://dx.doi.org/10.53761/1.19.1.10.
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Student Evaluation of Teaching (SET) results play an important role in academic staff performance evaluation, but also in promotion processes. However, there is much evidence to suggest that the SET used in most universities across the Anglosphere has traditionally penalised female academics. As universities manage the recovery phase of the COVID-19 pandemic, they will also need to take into account the effect of remote teaching on the validity of student evaluation data. Given SET are critical to promotion success, it is important to then understand the gendered effect of remote teaching on student evaluations. We aimed to evaluate how intrusions of family life, academics’ home environment and competence with remote teaching technology of female academics were viewed by students and if there were noticeable differences in SET data. We analysed 22,485 SET data over 2019 (pre-COVID, face-to-face teaching) and 2020 (COVID-lockdowns, remote teaching) for female and male academics, matched with student gender, in the multidisciplinary First Year College at Victoria University, Melbourne Australia. Our results showed that there were no differences in the score ratings for teacher gender. However, the qualitative data showed that whilst overall there were overwhelmingly positive comments for both male and female teachers, there was an increase in the negative comments on teaching style by male students toward their female teachers during remote teaching and overall more comments relating to attitude. We speculate that this would have a negative impact on the confidence of teaching-intensive female academics hindering their leadership aspirations and career progression in academia.
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Mulcahy, Sean Alexander, and Sean Mulcahy. "Acting Law | Law Acting: A Conversation with Dr Felix Nobis and Professor Gary Watt." Exchanges: The Interdisciplinary Research Journal 4, no. 2 (April 30, 2017): 189–200. http://dx.doi.org/10.31273/eirj.v4i2.158.
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Dr Felix Nobis is a senior lecturer with the Centre for Theatre and Performance at Monash University. He has worked as a professional actor for many years. He previously played an assistant to the Crown Prosecutor in the Australian television series, Janus, which was set in Melbourne, Victoria and based on the true story of a criminal family allegedly responsible for police shootings. He also played an advisor to a medical defence firm in the Australian television series MDA. He is a writer and professional storyteller. He has toured his one-person adaptation of Beowulf (2004) and one-person show Once Upon a Barstool (2006) internationally and has written on these experiences. His most recent work Boy Out of the Country (2016) is written in an Australian verse style and has just completed a tour of regional Victoria. Professor Gary Watt is an academic in the School of Law at the University of Warwick where his teaching includes advocacy and mooting. He also regularly leads rhetoric workshops at the Royal Shakespeare Company. He is the author of Dress, Law and Naked Truth (2013) and, most recently, Shakespeare’s Acts of Will: Law, Testament and Properties of Performance (2016), which explores rhetoric in law and theatre. He also co-wrote A Strange Eventful History, which he performed with Australian choral ensemble, The Song Company, to mark the 400th anniversary of Shakespeare’s death.
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Marrone, J., C. K. Fairley, M. Saville, C. Bradshaw, F. J. Bowden, B. Donovan, and J. S. Hocking. "31. WHY HAS TRICHOMONAS VAGINALIS DECLINED DRAMATICALLY AMONG VICTORIAN WOMEN (1947-2005)?" Sexual Health 4, no. 4 (2007): 296. http://dx.doi.org/10.1071/shv4n4ab31.
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Trichomonas vaginalis (TV) diagnosis rates have decreased considerably in some countries during the last two decades. It is unclear why TV has decreased only in some countries. This study investigated the relationships between: 1) TV diagnosis rates among women attending the Melbourne Sexual Health Centre (MSHC), and among Pap smears screened by Victorian Cytology Services (VCS); 2) the use of nitroimidazoles in Australia and; 3) gonorrhoea notification data for Victoria to assess changes in sexual behaviour. TV diagnosis rates among women attending MSHC rose from under 5% in the 1940's, to 20% to 30% in the 1960's and then declined 5% to 10% during the 1970's. From 1980 onwards, TV diagnosis rates fell progressively to below 1% by 1991, with 0.1% in 2004. A similar pattern was seen in TV at VCS, but with lower absolute percentages. Metronidazole was introduced into Australia in 1961 and tinidazole in 1976 and by 1987 there were 400 000 nitroimidazole prescriptions per year. Pap smear screening in Victoria began in 1965, only including 20% of women per year (aged 15 to 69) by the mid 1980's. Post 1980's, screening rose until 2000, stabilising at 35% of women per year. Gonorrhoea notification rates peaked during times TV was experiencing its greatest falls. The initial decline of TV seen in Victoria was associated with the introduction of effective antibiotics. The further decline to less than 1% was seen when Pap smear screening participation increased during the 1990's.
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Rose, Louise, Sioban Nelson, Linda Johnston, and Jeffrey J. Presneill. "Decisions Made By Critical Care Nurses During Mechanical Ventilation and Weaning in an Australian Intensive Care Unit." American Journal of Critical Care 16, no. 5 (September 1, 2007): 434–43. http://dx.doi.org/10.4037/ajcc2007.16.5.434.
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Background Responsibilities of critical care nurses for management of mechanical ventilation may differ among countries. Organizational interventions, including weaning protocols, may have a variable impact in settings that differ in nursing autonomy and interdisciplinary collaboration. Objective To characterize the role of Australian critical care nurses in the management of mechanical ventilation. Methods A 3-month, prospective cohort study was performed. All clinical decisions related to mechanical ventilation in a 24-bed, combined medical-surgical adult intensive care unit at the Royal Melbourne Hospital, a university-affiliated teaching hospital in Melbourne, Victoria, Australia, were determined. Results Of 474 patients admitted during the 81-day study period, 319 (67%) received mechanical ventilation. Death occurred in 12.5% (40/319) of patients. Median durations of mechanical ventilation and intensive care stay were 0.9 and 1.9 days, respectively. A total of 3986 ventilation and weaning decisions (defined as any adjustment to ventilator settings, including mode change; rate or pressure support adjustment; and titration of tidal volume, positive end-expiratory pressure, or fraction of inspired oxygen) were made. Of these, 2538 decisions (64%) were made by nurses alone, 693 (17%) by medical staff, and 755 (19%) by nurses and staff in collaboration. Decisions made exclusively by nurses were less common for patients with predominantly respiratory disease or multiple organ dysfunction than for other patients. Conclusions In this unit, critical care nurses have high levels of responsibility for, and autonomy in, the management of mechanical ventilation and weaning. Revalidation of protocols for ventilation practices in other clinical contexts may be needed.
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Dwyer, Alison, and John McNeil. "Are Clinical Registries Actually Used? The Level of Medical Staff Participation in Clinical Registries, and Reporting within a Major Tertiary Teaching Hospital." Asia Pacific Journal of Health Management 11, no. 1 (March 16, 2016): 56–64. http://dx.doi.org/10.24083/apjhm.v11i1.245.
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Clinical Registries are established to provide a clinically credible means for monitoring and benchmarking healthcare processes and outcomes, to identify areas for improvement, and drive strategies for improving patient care. Clinical Registries are used to assess changes in clinical practice, appropriateness of care and health outcomes over time. The American Heart Association Policy Statement in April 2011 called for expanding the application for existing and future Clinical Registries, with well-designed Clinical Registry programs. Concurrently, in Australia, and similarly within the United States and United Kingdom, there has been an increased focus on performance measurement for quality and patient safety. Within Victoria, the Victorian Clinical Governance Policy Framework outlines clinical effectiveness as one of the four domains of Clinical Governance
As Clinical Registries evaluate effectiveness and safety of patient care by measuring patient outcomes compared with peers, the use of Clinical Registries data to improve a health service’s quality of care seems intuitive. A mixed methods approach was utilised, involving (1) semi-structured interviews and (2) documentation audit in this study conducted at Austin Health, a major tertiary teaching hospital in North-Eastern metropolitan Melbourne, affiliated with the University of Melbourne and various research institutes within Austin LifeSciences.
Although many studies have highlighted the benefits of data collected via individual Clinical Registries, [5,6] the level of voluntary medical staff participation in Clinical Registries at a health service level is yet to be established. The aim of this study was to document the level of medical staff involvement for Clinical Registries within a major tertiary teaching hospital, and the level of reporting into Quality Committees within the organisation.
This study demonstrates that along with a very high level of medical staff participation in Clinical Registries, there is a lack of systematic reporting of Registries data into quality committees beyond unit level, and utilisation of such data to reflect upon practice and drive quality improvement.
Abbreviations: CREPS – Centre for Excellence in Patient Safety; CSU – Clinical Services Unit; HOU – Heads of Unit; VASM – Victorian Audit of Surgical Mortality.
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Weiss, John, Kathryn Sheffield, Anna Weeks, and David Smith. "Modelling the Incursion and Spread of a Forestry Pest: Case Study of Monochamus alternatus Hope (Coleoptera: Cerambycidae) in Victoria." Forests 10, no. 2 (February 22, 2019): 198. http://dx.doi.org/10.3390/f10020198.
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Effective and efficient systems for surveillance, eradication, containment and management of biosecurity threats require methods to predict the establishment, population growth and spread of organisms that pose a potential biosecurity risk. To support Victorian forest biosecurity operations, Agriculture Victoria has developed a landscape-scale, spatially explicit, spatio-temporal population growth and dispersal model of a generic pest pine beetle. The model can be used to simulate the incursion of a forestry pest from a nominated location(s), such as an importation business site (approved arrangement, AA), into the surrounding environment. The model provides both illustrative and quantitative data on population dynamics and spread of a forestry pest species. Flexibility built into the model design enables a range of spatial extents to be modelled, from user-defined study areas to the Victoria-wide area. The spatial resolution of the model (size of grid cells) can be altered from 100 m to greater than 1 km. The model allows core parameters to be altered by the user, enabling the spread of a variety of windborne insect species and pathogens to be investigated. We verified the model and its parameters by simulating and comparing the outputs with the 1999/2000 Melbourne incursion, but no establishment of a forestry pest beetle was believed to be Monochamus alternatus Hope (Coleoptera: Cerambycidae). The model accurately predicts the distance and direction of the historic incursion, and the subsequent failure to establish is due to low overall population density of the pest species.
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Prain, Vaughan, and Tony Booth. "Using Interactive Television to Deliver Professional Development Programs in Rural Victoria." Australian and International Journal of Rural Education 3, no. 2 (July 1, 1993): 5–10. http://dx.doi.org/10.47381/aijre.v3i2.373.
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In 1991 the Regional Telematics Educatiou Consortium (RTEC) was established to promote and co-ordinate the telematic delivery of education and training programs in rural Victoria. 'Telematics' is defined as all electronically-delivered communication, including audio and audiographic conferencing, and one or two-way video transmission. Interactive television programs were first trialled in 1991 in the Loddon Campaspe Mallee Region, and expanded to over twenty programs in 1992. While many of these programs consisted of only one or two sessions, the Promoting Effective Teaching and Learning Program (PETL), a professional development course of six ITV sessions supported by one initial face-to-face session, provided more data on presenter and participant initial perceptions and responses. Eleven presenters delivered PETL to two hundred and forty-one teachers at twenty-three sites in the Loddon Campaspe Mallee Region during 1992.
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Munchan, Leanne, and Joseph Agbenyega. "Exploring early childhood educators’ experiences of teaching young children with disability." Australasian Journal of Early Childhood 45, no. 3 (July 31, 2020): 280–91. http://dx.doi.org/10.1177/1836939120944635.
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This paper argues that whilst inclusive education in early childhood is gaining wider acceptance in the equity and diversity movement, the value and contribution of educators’ voices about what is working and challenging are frequently ignored. This small-scale research explored five early childhood educators’ understandings and experiences of inclusive education in two kindergartens in Victoria, Australia. A thematic analysis of the data highlights inclusion as a right to belong and fully participate; the need for modifications to orchestrate a culture of acceptance, diversity and inclusion; a lack of support and inadequate professional learning; and supporting effective practice through relationship with families, experts and children. The findings draw implications of evidence-based professional learning that is less focused on the interests of academic researchers and policy makers and more on the everyday needs of early childhood educators.
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Pang, Toh Yen, Frank Feltham, and Elena Pirogova. "Innovation in Biomedical Engineering Education During the COVID-19 Pandemic." Asian Education Studies 5, no. 2 (December 7, 2020): 29. http://dx.doi.org/10.20849/aes.v5i2.814.
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This paper addresses challenges that arose during the on-going coronavirus pandemic and methodologies implemented in teaching a Biomechanics course in the Biomedical Engineering program (Biomedical and Electrical Engineering Discipline, Faculty of Engineering, RMIT University, Melbourne, Australia). We aimed to address the requirements for a quick transition of the entire curriculum to efficient remote delivery of the course, which involved: (i) providing authentic learning experiences; (ii) keeping students motivated and engaged with their classes and team projects; and (iii) preventing students from cheating when completing online assessments. The specific tools, software packages and approaches employed to support the remote teaching and learning are presented and discussed in this paper. Effective and on-going communication with students was crucial for managing their expectations, engagement with the course materials and teaching team, retaining positive learning experiences and for their overall well-being. The Socratic approach used in developing the online assessments was able to promote students’ critical thinking, problem solving and self-reflection and assisted the teaching team in minimising online cheating.
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Mitchell, Paul, Jennifer Soon, Joanne Kenny, and Katherine Simons. "What do doctors value about attending multi-disciplinary cancer case discussions?" Journal of Clinical Oncology 37, no. 15_suppl (May 20, 2019): e18324-e18324. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.e18324.
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e18324 Background: Discussion of cancer cases at multi-disciplinary meetings (MDMs) for treatment planning is expected standard care in Australia. There has been rapid uptake of MDMs in the last 10 - 15 years and in the state of Victoria approximately 70% of cancer cases are discussed. MDMs have strong support from medical staff and we investigated their motivation in attending MDMs. Methods: Over 12 months, Austin Health in Melbourne, Victoria, hosted 452 cancer MDMs discussing 5943 patients. MDMs covered 15 tumour areas: 11 solid tumour, one lymphoma and three haematological. Over a 4-week period, medical staff attending MDMs were surveyed and asked to rank what they valued most about cancer MDMs, over and above the benefits for patients. Results: Responses were received from 84% of the 285 medical staff surveyed, which included consultants as well as trainees (registrars and fellows). For 75% of respondents the highest ranking was given to multi-disciplinary communication, 9% gave the highest ranking to quality assurance and governance, 5% ongoing learning for consultants, 5% collegiate relationships, 2% learning and teaching for non-consultant staff, 2% peer support 1% job satisfaction and 1% clinical trials engagement. Similar results were obtained for consultant staff and for registrars / fellows. For consultant medical staff, if multidisciplinary communication was excluded, 44% of respondents gave the highest ranking to quality assurance and governance, 23% to collegiate relationships, 20% ongoing learning for consultants, 10% peer support and 3% clinical trials engagement. Conclusions: When we asked doctors what they valued most about attending cancer MDMs, besides the benefits for patients, communication between disciplines was clearly the most valued aspect. The benefits for quality and governance was the next most valued, then collegiate relationships and peer support, and ongoing learning.
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Downer, Sean R., John G. Meara, Annette C. Da Costa, and Kannan Sethuraman. "SMS text messaging improves outpatient attendance." Australian Health Review 30, no. 3 (2006): 389. http://dx.doi.org/10.1071/ah060389.
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Objective: To evaluate the operational and financial efficacy of sending short message service (SMS) text message reminders to the mobile telephones of patients with scheduled outpatient clinic appointments. Design: Cohort study with historical control. Setting: Royal Children's Hospital, Melbourne, Victoria. Patients: Patients who gave a mobile telephone contact number and were scheduled to attend an outpatient clinic at the Royal Children's Hospital, Melbourne in October, November and December 2004 (trial group) or in October, November and December 2003 (historical control group). Main outcome measures: Failure-to-attend (FTA) rate compared between the trial group, whose members were sent a reminder, and the historical control group, whose members were not sent a reminder. Financial benefits versus cost of sending reminders. Results: 22 658 patients with a mobile telephone contact number scheduled to attend an outpatient clinic appointment in October, November and December 2004 were sent an SMS reminder; 20 448 (90.2%) of these patients attended their appointment. The control group included 22 452 patients with a mobile telephone contact number scheduled to attend an appointment, with 18 073 (80.5%) patients attending. The FTA rate was significantly lower in the trial group than in the historical control group (9.8% v 19.5%; P < 0.001). The cost of sending the SMS reminders was small compared with the increase in patient revenue and associated benefits generated as a result of improved attendance. Conclusions: The observed reduction in FTA rate was in line with that found using traditional reminder methods and a prior pilot study using SMS. The FTA reduction coupled with the increase in patient revenue suggests that reminding patients using SMS is a very cost effective approach for improving patient attendance.
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Kong, F., C. Kyle-Link, J. Hocking, and M. Hellard. "11. SEX AND SPORT: A COMMUNITY BASED PROJECT OF CHLAMYDIA TESTING AND TREATMENT IN RURAL AND REGIONAL VICTORIA." Sexual Health 4, no. 4 (2007): 288. http://dx.doi.org/10.1071/shv4n4ab11.
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Chlamydia is the most common notifiable infectious disease in Australia with the number of notifications increasing 92% over the past 5 years. The "Sex and Sport" Project is piloting a community based chlamydia testing and treatment program reaching young people in a specific community setting, sporting clubs. This multifaceted approach utilises health education, population screening and collection of data on risk taking behaviour as the first steps in enhancing health and shaping future service provisions. The project's primary aim is to assess the feasibility of an outreach testing and treatment program. Secondary aims are to measure the prevalence of chlamydia and assess sexual risk behaviour in this population. Strong community collaborations and integration into local health services through the Primary Care Partnerships is important in the project's sustainability; in particular key community members respected by sporting clubs needed to be identified, capacity developed to deliver effective health promotion messages and improve young people's access to sexual health services. Additionally, local knowledge has guided overall program implementation and provides opportunities for capacity building to regionally based services. For example, poor access to sexual health services is being addressed by the participants being able to access services via telephone consultation with Melbourne Sexual Health Centre. Approximately 1000 Victorians aged 16-25 years from the Loddon Mallee region of Victoria will be tested between June and September 2007. This paper will report on the feasibility, challenges and possible solutions in establishing a community based outreach testing and treatment program.
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Davey, Belinda, Kristine Elliott, and Maria Bora. "Negotiating pedagogical challenges in the shift from face-to-face to fully online learning: A case study of collaborative design solutions by learning designers and subject matter experts." Journal of University Teaching and Learning Practice 16, no. 1 (January 1, 2019): 26–46. http://dx.doi.org/10.53761/1.16.1.3.
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With the increasing number of students enrolled in fully online programs and subjects across different Australian universities, online education has become a popular higher education alternative. The University of Melbourne has responded to this challenge by establishing the Melbourne School of Professional and Continuing Education (MSPACE), where the learning designers (LDs), project managers, educational technologists, graphic designers and video producers work collaboratively with subject matter experts (SMEs) from across the university to create high-quality fully online graduate subjects. The case study presented in this article examines how MSPACE used this team-based approach to design and develop Psychodynamic Psychiatry, a six-week elective in the Master of Psychiatry. This paper examines a number of pedagogical challenges that arise when converting a pre-existing face-to-face subject to a fully online subject, as well as some relatively unique aspects in the design and development process utilised by MSPACE. While the approach provided by MSPACE currently focuses on supporting SMEs by providing access to third-space professionals, it is hoped that this will act as a conduit through which the SMEs are enculturated into the ways of design thinking for effective online teaching and learning practice.
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Charleson, A. W. "Seismic design within architectural education." Bulletin of the New Zealand Society for Earthquake Engineering 30, no. 1 (March 31, 1997): 46–50. http://dx.doi.org/10.5459/bnzsee.30.1.46-50.
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This paper discusses the teaching of earthquake resistant design within schools of architecture. It aims to stimulate discussion on more effective means of teaching the subject, and to suggest ideas and resources for schools whose seismic design curriculum might benefit from further development.
It is argued that seismic design issues should be included and integrated into architecture curricula. The case is based primarily on observations of building failures resulting from flawed architectural design decisions and subsequent critical reaction from within the architectural profession itself. However, another reason is that the large sizes and restrictive layouts of some seismic load resisting systems impact unavoidably upon architectural layouts.
The content, teaching methods and teaching staff qualities appropriate for a seismic design curriculum are discussed in a case study from the School of Architecture, Victoria University of Wellington. Two key aspects of perceived success are the course's relevance to architectural design and the variety of presentation. Teaching methods, teaching aids and useful references are provided.
The evaluation of the courses considered in the case study is discussed, and postgraduate and post-graduation seismic education in New Zealand is reviewed.
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Gleadow, Roslyn, and Barbara Macfarlan. "Design for learning – a case study of blended learning in a science unit." F1000Research 4 (September 24, 2015): 898. http://dx.doi.org/10.12688/f1000research.7032.1.
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Making material available through learning management systems is standard practice in most universities, but this is generally seen as an adjunct to the ‘real’ teaching, that takes place in face-to-face classes. Lecture attendance is poor, and it is becoming increasingly difficult to engage students, both in the material being taught and campus life. This paper describes the redevelopment of a large course in scientific practice and communication that is compulsory for all science students studying at our Melbourne and Malaysian campuses, or by distance education. Working with an educational designer, a blended learning methodology was developed, converting the environment provided by the learning management system into a teaching space, rather than a filing system. To ensure focus, topics are clustered into themes with a ‘question of the week’, a pre-class stimulus and follow up activities. The content of the course did not change, but by restructuring the delivery using educationally relevant design techniques, the content was contextualised resulting in an integrated learning experience. Students are more engaged intellectually, and lecture attendance has improved. The approach we describe here is a simple and effective approach to bringing this university’s teaching and learning into the 21st century.
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Gleadow, Roslyn, Barbara Macfarlan, and Melissa Honeydew. "Design for learning – a case study of blended learning in a science unit." F1000Research 4 (November 16, 2015): 898. http://dx.doi.org/10.12688/f1000research.7032.2.
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Making material available through learning management systems is standard practice in most universities, but this is generally seen as an adjunct to the ‘real’ teaching, that takes place in face-to-face classes. Lecture attendance is poor, and it is becoming increasingly difficult to engage students, both in the material being taught and campus life. This paper describes the redevelopment of a large course in scientific practice and communication that is compulsory for all science students studying at our Melbourne and Malaysian campuses, or by distance education. Working with an educational designer, a blended learning methodology was developed, converting the environment provided by the learning management system into a teaching space, rather than a filing system. To ensure focus, topics are clustered into themes with a ‘question of the week’, a pre-class stimulus and follow up activities. The content of the course did not change, but by restructuring the delivery using educationally relevant design techniques, the content was contextualised resulting in an integrated learning experience. Students are more engaged intellectually, and lecture attendance has improved. The approach we describe here is a simple and effective approach to bringing this university’s teaching and learning into the 21st century.
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LANTSBERG, Daniel, Yossi MIZRACHI, and Darren KATZ. "Micro-TESE Outcomes for Non-Obstructive Azoospermia — The First Australian Series." Fertility & Reproduction 04, no. 03n04 (September 2022): 140. http://dx.doi.org/10.1142/s2661318222740528.
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Background: Micro-dissection testicular sperm extraction (micro-TESE) for non-obstructive azoospermia (NOA) was shown to achieve the best sperm retrieval rate (SRR) compared to other techniques. However, to date there is no large series of published Australian data. Aim: To study the incidence and predicting factors of successful sperm extraction in men with NOA undergoing micro-TESE in Victoria. Method: We retrospectively analyzed the clinical data of all consecutive patients with confirmed NOA who were treated between August 2014 and April 2020 in a single medical centre in Melbourne, Victoria. None were excluded. Patients underwent micro-TESE and upon a successful sperm retrieval, sperm was either frozen for fertility preservation or used fresh for ICSI. Results: During the study period, 85 men with NOA underwent micro-TESE in our centre. The overall sperm retrieval rate (SRR) was 61.2% (52/85). All patients with a history of surgically treated cryptorchidism or childhood diseases had a successful sperm retrieval. Patients with Kleinfelter syndrome had a 75% SRR. Patients with Idiopathic NOA and patients with a history of chemotherapy had a 50% and 40% SRR, respectively. Among the different types of testicular pathology, the highest SRR was found in men with complete hyalinization (100%). Hypospermatogenesis was associated with a high SRR of 93.3%, while Sertoli-cell-only histology was associated with only 46.3% SRR. The SRR has significantly increased from 33.3% in 2015-2016 to 73.6% in 2019-2020 (p=0.003). On Multivariate logistic regression analysis, baseline FSH levels <20 IU and history of childhood disease or Klinefelter syndrome were significantly associated with successful sperm retrieval. The cumulative pregnancy rate was 23.7%. Conclusion: This first report from Australia indicates that micro-TESE is an effective method for the treatment of NOA with high SRR and pregnancy rate. Our results can help patient management and counseling.
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Lingard, Helen, Rita Peihua Zhang, and David Oswald. "Effect of leadership and communication practices on the safety climate and behaviour of construction workgroups." Engineering, Construction and Architectural Management 26, no. 6 (July 15, 2019): 886–906. http://dx.doi.org/10.1108/ecam-01-2018-0015.
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Purpose The leadership style and communication practices of supervisors in the Australian construction industry were measured. The purpose of this paper is to investigate the effect of leadership style and communication practices of Australian construction supervisors on workgroup health and safety (H&S) climate and behaviour. Design/methodology/approach A questionnaire was administered to members of 20 workgroups engaged in rail construction work on the Level Crossing Removal Project and the Melbourne Metro Tunnel Project in Victoria, Australia. The survey measured components of supervisors’ transformational and transactional leadership, communication practices, the group H&S climate and workers’ self-reported H&S compliance and participation. Findings Supervisors’ transformational and transactional leadership, as well as communication practices, were all positively and significantly correlated with group H&S climate and workers’ self-reported H&S behaviours. The transformational leadership component of providing an appropriate model was the strongest predictor of H&S participation, while H&S compliance was predicted by the transactional leadership component of providing contingent reward, as well as supervisors’ communication practices. H&S climate fully mediated the relationship between supervisory leadership and workers’ self-reported H&S behaviour. Originality/value The research demonstrates that both transformational and transactional supervisory leadership are important in the construction context. Effective communication between supervisors and workers is also important for H&S. The findings suggest that supervisory leadership development programmes may be an effective way to improve H&S performance in predominantly subcontracted construction workgroups.
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Tracy, Jane M. "People with an intellectual disability in the discourse of chronic and complex conditions: an invisible group?" Australian Health Review 33, no. 3 (2009): 478. http://dx.doi.org/10.1071/ah090478.
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TO THE EDITOR: Goddard et al, authors of ?People with an intellectual disability in the discourse of chronic and complex conditions: an invisible group??1 are to be congratulated for raising discussion about one of the most vulnerable groups in Australia with respect to their receipt of optimal health care. The authors conclude that ?developing interventions and strategies to increase the knowledge of health care workers . . . caring for people with intellectual disabilities will likely improve the health care needs of this population and their families?. In relation to this identified need for health professional education and training in the care of people with intellectual disabilities, we would like to draw the attention of your readers to some work undertaken by the Centre for Developmental Disability Health Victoria (CDDHV) to address this issue. The CDDHV works to improve the health and health care of people with developmental disabilities through a range of educational, research and clinical activities. In recent years there has been an increasing awareness of the need for health professional education in this area. Moreover, as people with disabilities often have chronic and complex health and social issues, focusing on their health care provides a platform for interprofessional education and a springboard for understanding the essential importance and value of interprofessional practice. Recently, the CDDHV has taken a lead role in developing a teaching and learning resource that focuses both on the health care of people with disabilities and on the importance and value of interprofessional practice. This resource promotes and facilitates interprofessional learning, and develops understanding of the health and health care issues experienced by people with disabilities and those who support them. ?Health and disability: partnerships in action? is a new video-based teaching and learning package, produced through an interprofessional collaboration between health professionals from medicine, nursing, occupational therapy, physiotherapy, paramedic practice, health science, social work, speech pathology, dietetics and dentistry. Those living with a disability are the experts on their own experience and so their direct involvement in and contribution to the education of health care professionals is essential. The collaboration between those featured in the video stories and health professionals has led to the development of a powerful resource that facilitates students and practitioners developing insights into the health and health care issues encountered by people with developmental disabilities. We also believe that through improving their understanding of, and health provision to, people with disabilities and those who support them, health professionals will acquire valuable attitudes, knowledge and skills applicable to many other patients in their practice population. Jane M Tracy Education Director Centre for Developmental Disability Health Victoria Melbourne, VIC
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D’Arcy, Catherine, Ann Taket, and Lisa Hanna. "Implementing empowerment-based Lay Health Worker programs: a preliminary study." Health Promotion International 34, no. 4 (April 24, 2018): 726–34. http://dx.doi.org/10.1093/heapro/day023.
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Abstract Lay Health Worker (LHW) programs have been shown to be effective in engaging community members in health promotion. While successful LHW program implementation requires an understanding of factors influencing program effectiveness, evidence informing such understanding is lacking for empowerment and ecological theory-based LHW programs. This descriptive study explores how enablers and barriers, identified from LHW literature apply (from the LHWs’ perspective) in the context of implementing an empowerment and ecological theory-based LHW model in Melbourne, Victoria. A qualitative case study was carried out. Data were collected from participating LHWs (n = 11) via anonymized online activity logs (n = 7) and semi-structured interviews (n = 7). Deductive-inductive thematic analysis was guided by five a priori themes identified from the literature: community relationships; intrinsic traits, values and motivations; capacity building; program design; and work conditions. Data supported the enablers and barriers to program effectiveness and implementation reported by previous research. Subthemes identified the importance of the LHW bridging role; the empowerment model; integrating the program; and program inclusiveness. This research contributes to the growing practice literature regarding how to effectively implement diverse LHW models in diverse settings. It also contributes to social ecological and complex systems-based health promotion practice evidence in suggesting LHWs to be potentially useful elements which may add to the effectiveness of ecologically based health promotion interventions.
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Chu, Isabel E.-Hui, Weranja Ranasinghe, Madeleine Nina Jones, and Philip McCahy. "Prone versus modified supine percutaneous nephrolithotomy: which is more cost effective in an Australian tertiary teaching hospital?" Journal of Clinical Urology 12, no. 5 (December 20, 2018): 391–95. http://dx.doi.org/10.1177/2051415818817131.
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Introduction: Percutaneous nephrolithotomy is currently one of the main treatment options for large renal stones, but the effect of positioning on comparative costing has been scarcely documented. We aimed to compare the cost effectiveness of modified supine with traditional prone percutaneous nephrolithotomy procedures in the context of Victoria, Australia. Materials and methods: A prospective group of 236 renal units (224 patients) was included in the two-site study, with 76 performed in the prone position and 160 performed in the modified supine position. Costing was calculated using a ‘bottom-up’, all-inclusive framework that generates per-hour costs for theatre, recovery unit and ward costs from base costs and maintenance costs. Percutaneous nephrolithotomy-specific equipment was added to calculate comparative costs of modified supine versus prone procedures. Chi squared and T tests were used for statistical analysis. Results: There was a significant difference in the overall costing between the modified supine and prone groups. The modified supine group had a lower total cost (AUD$6424.29) compared to the prone group (AUD$7494.79) ( P=0.007), lower operative costs (AUD$4250.93 vs. AUD$5084.29, P=0.002) and lower ward costs (AUD$533.55 vs. AUD$1130.20, P<0.001). There was no significant difference in recovery times in the modified supine and prone groups, although the modified supine group appeared to have shorter recovery times (AUD$690.69 vs. AUD$586.05, P=0.209). Conclusions: Modified supine percutaneous nephrolithotomy has significantly lower total costs, operative costs and ward costs compared to prone percutaneous nephrolithotomy. Larger randomised trials are needed to assess these findings further. Level of evidence: Not applicable for this multicentre audit.
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Fraser, Heather, Nik Taylor, and Tania Signal. "Young people empathising with other animals: reflections on an Australian RSPCA Humane Education Program." Aotearoa New Zealand Social Work 29, no. 3 (September 25, 2017): 5–16. http://dx.doi.org/10.11157/anzswj-vol29iss3id384.
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INTRODUCTION: Empathy is associated with engagement, compassion, social support and emotional sensitivity, and it is a hallmark of good social work practice. Empathy rightfully receives much attention in social work practice, however, interspecies empathy has yet to be included. This article has been written to address this gap.METHODS: Two main research questions guide our conceptual discussion of young people, interspecies empathy and social work: (1) Why is empathy important to social work with young people? (2) What can an Australian RSPCA Humane Education Programme (HEP) teach social workers about the benefits of interspecies empathy for young people? After our literature review, we examine our illustrative example, which is an HEP offered mostly to newly arrived refugee and migrant young people living in the outer suburbs of Melbourne, whose prior experiences of and/or attitudes towards animals may not have been positive. FINDINGS: Social workers are wise to prioritise empathy because extensive research has shown that, across a diverse range of fields, modes of practice in and beyond social work, empathic practitioners are more effective, achieving better outcomes with their clients. From the letters the young people sent to the RSPCA Victoria after completing an HEP, we note their self-reported increases in empathy for animals, including those they had previously feared or shunned.CONCLUSION: There are many potential benefits of recognising, fostering and valuing interspecies empathy through humane education programmes. However, for these to be ethical, care and empathy must be shown towards the wellbeing of the animals involved, not just the human participants.
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Holloway, Edith E., Bonnie A. Sturrock, Ecosse L. Lamoureux, Jill E. Keeffe, and Gwyneth Rees. "Help seeking among vision-impaired adults referred to their GP for depressive symptoms: patient characteristics and outcomes associated with referral uptake." Australian Journal of Primary Health 21, no. 2 (2015): 169. http://dx.doi.org/10.1071/py13085.
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Adults with vision impairment commonly experience depression; however, depression often remains undetected and therefore untreated in this group. Using a prospective longitudinal design, the aim of this study was to determine the rate of uptake for a referral to a general practitioner (GP), in vision-impaired adults, who were screened for depression in low vision rehabilitation and eye-care settings. Fifty-seven vision-impaired adults (aged ≥18 years) were recruited from low vision rehabilitation centres across Australia and the Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, between June 2010 and May 2012. Participants screened positive for depressive symptoms and were referred to their GP for follow up. Telephone assessments took place at baseline, 3 and 6 months to determine uptake of a GP referral and changes in depressive symptoms over 6 months. Forty-six per cent of participants followed through with the GP referral. A desire for emotional support and stigma towards seeking support from a psychologist were significantly associated with uptake (both P < 0.05). GPs were more likely to recommend anti-depressant medication compared with a psychologist consultation (69% v. 54%) and patients themselves were more likely to take anti-depressant medication (94% v. 14% who saw a psychologist). Depressive symptoms decreased significantly over 6 months for those who followed through with a GP referral (baseline M = 10.04, s.d. = 5.76 v. 6-months M = 6.20, s.d. = 3.38; z = –2.26, P = 0.02) but not for those who did not use the GP referral (z = –1.92, P = 0.55). This method of referral to a GP following depression screening may provide an effective pathway to detect and manage depression in vision-impaired adults.
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Gunasekara, Asanka, Kristina Turner, Chorng Yuan Fung, and Con Stough. "Impact of lecturers’ emotional intelligence on students’ learning and engagement in remote learning spaces: A cross-cultural study." Australasian Journal of Educational Technology 38, no. 4 (November 4, 2022): 112–26. http://dx.doi.org/10.14742/ajet.7848.
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Higher education institutions have recently transitioned from face-to-face to online teaching and learning environments. However, academic staff lack sufficient training in applying emotional intelligence (EI) skills and strategies in online learning environments. Although literature addressing academics’ EI is sparse, some studies have suggested that lecturers’ EI greatly influences teaching and learning. This study used the concept of EI to understand students’ perceptions of how lecturers’ EI impacted their learning and engagement in an online learning environment. We conducted four online focus group interviews of 14 students pursuing a bachelor’s degree at two campuses of an Australian university, one in Melbourne and the other in Malaysia. Four main themes were identified using thematic analysis. Students discussed their perceptions and experiences on (a) vulnerabilities, coping and empathy; (b) relationships with lecturers, trust and safety; (c) communication, tone and voice; and (d) managing emotions of lecturers. Our findings suggest that lecturers’ EI impacted students’ learning and engagement in online learning spaces. However, the impact differs between Australia and Malaysia due to cultural differences. Drawing on the findings, we present online education good practices grounded in the theory of EI. Lecturers delivering online courses should consider employing these practices for effective teaching. Implications for practice or policy: Higher educational institutions need to support lecturers in developing the necessary EI skills to engage students in online learning. Lecturers need to make meaningful attempts to develop positive relationships with students in online forums to support students’ engagement. Lecturers working in online learning environments need to support students to develop friendships and connections with their peers. Lecturers need to include regular discussion breaks during online lectures to allow students to share their opinions and experiences.
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Thompson, Sandra C., and Maureen Norris. "Hepatitis B Vaccination of Personnel Employed in Victorian Hospitals: Are Those at Risk Adequately Protected?" Infection Control & Hospital Epidemiology 20, no. 01 (January 1999): 51–54. http://dx.doi.org/10.1086/501552.
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AbstractObjective:To examine the policies and practices in hospitals within the state of Victoria, Australia, with respect to vaccination of staff against hepatitis B infection.Design:A written self-administered questionnaire to be completed by the infection control officer (or designated officer for hepatitis B vaccination) within each hospital.Setting:Public (teaching and nonteaching) and private hospitals, including metropolitan and rural institutions in Victoria.Participants:A random sample of 30% of Victorian hospitals were asked to participate in the survey. Of 78 eligible institutions, 69 (88%) completed and returned questionnaires.Results:There was no consistent hepatitis B prevention policy in place across Victoria. Of the 69 responding hospitals, 63 (91%) offered hepatitis B vaccination to staff, and 58 (84%) of these also paid all costs of vaccination. Of the 63 hospitals offering vaccination to staff, 39 offered vaccination to all staff, 23 offered vaccination based on job title, and one offered vaccination based on anticipated exposure. In many institutions, postexposure protocols were recalled more readily than preexposure vaccination guidelines. Numerous respondents indicated a need for clear guidelines on policy and clarification on practical matters of management, such as acceptable immune levels, management of nonresponders to the primary series, and the need for, and timing of, booster doses of vaccine. Eleven (18%) of the 63 hospitals offering hepatitis B vaccination to staff undertook routine prevaccination screening, a practice not generally regarded as cost-effective in Australia. Fifty-five of these hospitals (91%) also undertook postvaccination screening.Conclusions:It is evident from this study that a considerable number of potentially susceptible healthcare personnel in Victorian hospitals remain unprotected against hepatitis B infection. A more reliable and consistent approach to preexposure hepatitis B vaccination is recommended
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Fisher, Jane, Tuan Tran, Stanley Luchters, Thach D. Tran, David B. Hipgrave, Sarah Hanieh, Ha Tran, et al. "Addressing multiple modifiable risks through structured community-based Learning Clubs to improve maternal and infant health and infant development in rural Vietnam: protocol for a parallel group cluster randomised controlled trial." BMJ Open 8, no. 7 (July 2018): e023539. http://dx.doi.org/10.1136/bmjopen-2018-023539.
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IntroductionOptimal early childhood development is an international priority. Risks during pregnancy and early childhood have lasting effects because growth is rapid. We will test whether a complex intervention addressing multiple modifiable risks: maternal nutrition, mental health, parenting capabilities, infant health and development and gender-based violence, is effective in reducing deficient cognitive development among children aged two in rural Vietnam.Methods and analysisThe Learning Clubs intervention is a structured programme combining perinatal stage-specific information, learning activities and social support. It comprises 20 modules, in 19 accessible, facilitated groups for women at a community centre and one home visit. Evidence-informed content is from interventions to address each risk tested in randomised controlled trials in other resource-constrained settings. Content has been translated and culturally adapted for Vietnam and acceptability and feasibility established in pilot testing.We will conduct a two-arm parallel-group cluster-randomised controlled trial, with the commune as clustering unit. An independent statistician will select 84/112 communes in Ha Nam Province and randomly assign 42 to the control arm providing usual care and 42 to the intervention arm. In total, 1008 pregnant women (12 per commune) from 84 clusters are needed to detect a difference in the primary outcome (Bayley Scales of Infant and Toddler Development Cognitive Score <1 SD below standardised norm for 2 years of age) of 15% in the control and 8% in the intervention arms, with 80% power, significance 0.05 and intracluster correlation coefficient 0.03.Ethics and disseminationMonash University Human Research Ethics Committee (Certificate Number 20160683), Melbourne, Victoria, Australia and the Institutional Review Board of the Hanoi School of Public Health (Certificate Number 017-377IDD- YTCC), Hanoi, Vietnam have approved the trial. Results will be disseminated through a comprehensive multistranded dissemination strategy including peer-reviewed publications, national and international conference presentations, seminars and technical and lay language reports.Trial registration numberACTRN12617000442303; Pre-results.
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Cuthbert, Denise, and Marian Quartly. "Adoption, fostering, permanent care and beyond Re-thinking policy and practice on out-of-home care for children in Australia." Children Australia 35, no. 2 (2010): 2–5. http://dx.doi.org/10.1017/s1035077200000985.
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The papers published in this special issue of Children Australia were originally presented at a two day symposium held in Melbourne on 26 and 27 November 2009. The symposium, Adoption, fostering, permanent care and beyond: Re-thinking policy and practice on out-of-home care for children in Australia, was jointly convened by the Department of Human Services (DHS), Victoria and the School of Political and Social Inquiry at Monash University in conjunction with the History of Adoption in Australia project (Monash University 2009).The event was a partnership between professionals working in this area and university researchers. Each group brought different perspectives and imperatives to the table. For DHS and the sector, the immediate frame of the symposium was the major policy statement Directions for out-of-home care, announced in May 2009 by the Victorian Minister for Community Services after consultation with community service organisations and young people living in care (DHS 2009a). It announces a framework for change which incorporates action on seven fronts or ‘reform directions’. These are to support children to remain at home with their families; to provide a better choice of care placement; to promote wellbeing; to prepare young people who are leaving care to make the transition into adult life; to improve the education of children in care; to develop effective and culturally appropriate responses to the high numbers of Aboriginal children in our care; and to create a child-focused system and processes (DHS 2009a). The driving principle informing the reforms is to ensure that policy and service provision are centred on the needs and interests of children and young people, and to ensure that young people are consulted as to what their needs are (rather than assumptions being made by adults as to their needs).
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Dantas, Arianne M., and Robert E. Kemm. "A blended approach to active learning in a physiology laboratory-based subject facilitated by an e-learning component." Advances in Physiology Education 32, no. 1 (March 2008): 65–75. http://dx.doi.org/10.1152/advan.00006.2007.
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Learning via online activities (e-learning) was introduced to facilitate existing face-to-face teaching to encourage more effective student preparation and then informed participation in an undergraduate physiology laboratory-based course. Active learning was encouraged by hypothesis formation and predictions prior to classes, with opportunities for students to amend their e-learning submissions after classes. Automatic or tutor feedback was provided on student submissions. Evaluation of the course was conducted via student questionnaires, individual student interviews, and analysis of student marks in examinations and of the e-learning component. Student feedback on this entire subject in the university-wide quality of teaching survey was very high by University of Melbourne standards and most encouraging for the first implementation of such a curriculum modification. Results from further detailed surveys of student interactions and engagement and correlation analysis between student responses were also very supportive of the effectiveness of the course. There were no significant differences between examination marks in the new course with e-learning and the previous year without e-learning. However, there was a significant correlation between assessment of student e-learning work and their final examination mark. Correlation analysis between various survey responses helped interpret results and strengthened arguments for e-learning and suggested future improvements for student use of e-learning. This mode of e-learning used to support face-to-face learning activities in the laboratory can be adapted for other disciplines and may assist students in developing a greater appreciation and a deeper approach for learning from their practical class experiences.
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Tripathi, Parmanand. "Positive And Supportive Teacher Student Relationship." Think India 22, no. 2 (October 31, 2019): 2665–73. http://dx.doi.org/10.26643/think-india.v22i2.9391.
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Every teacher must realize that he/she needs to be highly motivated, committed, passionate, and optimistic towards his/her students as well as his/her teaching in order to create a positive and productive impact on the students and their learning outcomes. It is a proven fact that teachers who are sincere, caring, approachable, supportive and inspiring can easily enable their students to become enthusiastic, successful and creative learners. John Hattie, a proponent of Evidence Based Quantitative Research Methodologies on the Influences on Student achievement, who is also a Professor of Education and Director of the Melbourne Education Research Institute at the University of Melbourne, Australia, has noted in his study that a harmonious classroom can assist with the development of creativity as well as reduce anxiety levels amongst students. In my opinion, the primary objective of all effective and conscious teachers should be to promote a safe and healthy learning environment wherein students will feel confident, comfortable, happy and accepted. Time and again, I am convinced of the fact that only effective and conscious teachers understand, acknowledge and therefore, appreciate the significance of creating a rapport and bonding with their students for providing an education that is positive, productive and progressive. When teachers display a positive and congenial attitude towards their students, they not only make them ‘learn better, faster and deeper’ but make them self-confident and self-reliant too. Building positive, supportive, cooperative and mutually strong teacher-student relationships is the key to create a welcoming, healthy and conducive learning space in which students are enabled to thrive, prosper and go on to become what they are meant to be in life. And it is only by forging and nurturing a strong and positive relationship with their students, can teachers create a healthy and conducive learning atmosphere wherein students feel welcome, accepted, respected, loved and cared for, wherein learning becomes fun and joy. Conscious and committed teachers promote the art of positive parenting in every classroom and in every school to enable the students to become confident learners by willingly and happily shouldering the responsibility of being their ‘second parents’.When teachers teach with passion, display positive attitude towards their students and their success, and show genuine care for them, the students reciprocate with respect for their teachers, interest and love for their learning.
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Nguyen, T. M., Y. S. Hsueh, M. V. Morgan, R. J. Mariño, and S. Koshy. "Economic Evaluation of a Pilot School–Based Dental Checkup Program." JDR Clinical & Translational Research 2, no. 3 (May 5, 2017): 214–22. http://dx.doi.org/10.1177/2380084417708549.
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The objectives of this study were to perform an economic evaluation of a targeted school-based dental checkup program in northern metropolitan Melbourne, Victoria. A 12-mo retrospective case-control cohort analysis using the decision tree method evaluated the incremental cost-utility and cost-effectiveness ratio (ICUR/ICER) for passive standard care dental services and an outreach pilot intervention completed in 2013. A societal perspective was adopted. A total of 273 children ( n = 273) aged between 3 and 12 y met the inclusion/exclusion criteria: 128 in the standard care group and 145 in the intervention group. The total society costs included health sector costs, patient/family costs, and productivity losses in 2014 Australian dollars. Outcome measures were evaluated using quality-adjusted tooth years (QATY) and the combined deciduous and permanent decayed, missing, and filled teeth prevented (DMFT-prevented). A generic outcome variable was created to determine the impact of the intervention to reach underserved populations based on government concession eligibility (cardholder status). Uncertainties were incorporated using 95% confidence intervals. The mean total society cost per child is $463 and $291 ( P = 0.002), QATY utility difference is 0.283 and 0.293 ( P = 0.937), effectiveness difference is 0.16 and 0.10 ( P = 0.756), and cardholder status is 50.0% and 66.2% ( P = 0.007), respectively, for the standard care and intervention groups. On average per child, there was a cost saving of $172 and improvement of 0.01 QATY, with an additional proportion of 16.2% of cardholder children reached. The calculated ICER was $3,252 per DMFT-prevented. The intervention dominates standard care for QATY and per 1% cardholder reached outcome measures. Our study found the pilot checkup program was largely less costly and more effective compared with the current standard care. Further research is needed to quantify the value of outreach interventions to prevent dental caries development and progression in populations from low socioeconomic status. Knowledge Transfer Statement: The findings of this research demonstrated that an outreach dental program can be less costly and more effective than standard models of dental care. It showed that a school-based dental checkup program is beneficial despite other opinions that dental screening is ineffective as a method to improve public dental health. There is fiscal economic evidence to support broader expansion of similar programs locally and internationally to reduce dental caries for children from low-income families.
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Wong, Avelyn WY, Jim Tsaltas, Tom R. Manley, Roni T. Ratner, Cheryl CM Yim, and Oshri Barel. "Unsuspected uterine sarcomas undergoing morcellation: A retrospective multicenter study." Journal of Endometriosis and Pelvic Pain Disorders 10, no. 1 (February 21, 2018): 3–9. http://dx.doi.org/10.1177/2284026517748554.
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Objective: To evaluate the prevalence of unsuspected uterine sarcomas undergoing morcellation at the time of hysterectomy or myomectomy. Design: A retrospective cohort study. Settings: A teaching health service in Melbourne, Australia, consisting of four hospitals which provide gynecology and gynecology oncology services including one tertiary referral center. Population: All women undergoing any form of hysterectomy or myomectomy from 1998 to 2016. Methods: Patient demographics and the presence of morcellation were collected. All cases of confirmed uterine sarcomas were further examined and their histological subtype, patient demographics, preoperative investigations, and surgical indication were also identified. Results: A total of 7584 cases were studied. Overall, 33 uterine sarcomas were identified. Of these, seven cases were unsuspected malignancies. All seven cases were leiomyosarcomas. None of the malignant specimens underwent morcellation. The overall prevalence of uterine sarcomas in the total study population was 0.44%. The rate of unsuspected uterine sarcomas in women undergoing hysterectomy or myomectomy for presumed benign indications was 0.13% or 1 in 769. The rate of unintended morcellation of a uterine sarcoma in our center was 0%. The diagnosis of endometrial sarcoma was prompted by endometrial sampling in 58% of the cases when performed. Conclusion: The risk of inadvertent morcellation of unsuspected uterine sarcomas is low. Patients should be appropriately selected with adequate investigations and a detailed history and examination prior to surgery. Further studies are needed to identify effective preoperative screening methods for uterine sarcomas.
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Hill, Keith D., Michelle Vu, and Willeke Walsh. "Falls in the acute hospital setting — impact on resource utilisation." Australian Health Review 31, no. 3 (2007): 471. http://dx.doi.org/10.1071/ah070471.
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Objective: To determine the resource utilisation of patients who fall within an acute metropolitan hospital. Design: Retrospective observational study, part of a larger falls prevention project in a 323-bed acute care, tertiary teaching hospital in Melbourne, Australia. A review of falls incidents was undertaken for all patient admissions for 18 months from January 2002, excluding the Day Procedure Unit, Intensive Care Unit, Coronary Care Unit and the Emergency Department. Procedure: The most common diagnosis related groups (DRGs) associated with fallers were identified, and within each DRG, fallers were matched to non-fallers by age and gender. Difference in hospital length of stay (LOS) and disparity in resource consumption by these two groups were calculated. Results: The DRG with the highest proportion of fallers was 'Dementia and other chronic disturbances of cerebral function' (24%). Three of the top six DRGs had significantly longer LOS for fallers compared with non-fallers ('Delirium', 'Stroke' and 'Respiratory conditions') (P<0.05). Hospital-related costs were significantly higher for fallers compared with non-fallers for the DRG 'Stroke with severe/complicating diagnosis/procedure' only (P< 0.05). Conclusions: Inpatient LOS and total associated costs for patients who fell and were classified among the DRGs with the highest proportion of fallers were substantially higher than those of matched non-fallers. Effective falls prevention activities targeting these high-risk groups should be a priority, in the context of broader falls prevention activities within a hospital setting.
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Fisher, M., F. McRae, M. Pitcher, I. Hornung, and J. Spence. "Bridge of Support: A Collaborative Approach to a Peer Support Program." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 169s. http://dx.doi.org/10.1200/jgo.18.74600.
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Background and context: The Bridge of Support Program (BOS) is adapting a successful community based model of peer support to an acute setting, at the Sunshine Hospital Breast Clinic, to meet the cultural and socioeconomic diverse needs of women with breast cancer. This two year project was funded by LUCRF Community Partnership Trust. Aim: To improve the experience of women undergoing treatment of breast cancer at Western Health. To improve access to psych-social, emotional and practical support for women by extending the reach of CounterPart- a state-wide service of women´s Health Victoria, funded by the Victorian Department of Health and Human Services to provide peer support and information to people affected by breast or a gynecologic cancer. Program/Policy process: Peer support volunteers actively guided women to current and credible evidence-based information, support decision making and provide emotional support. Peer support volunteers are rostered once a week at Sunshine Hospital to coincide with breast clinic and include access to the day oncology unit and radiotherapy center. Detailed contact information is recorded and women receive follow-up contact (with consent) from the peer support volunteers at the CounterPart Resource Centre in Melbourne. A CounterPart staff member oversees the project and provides direct support and supervision to the volunteers on site at the hospital. Women can self refer. Outcomes: Between February and December 2016 the BOS program had 159 separate contacts with patients and their families. 82 contacts were with men and women who were new to CounterPart and 77 were follow-up contacts. 90 individuals treated for breast cancer at Western Health accessed the program, which represent 53% of the women seen by the breast service. 48% of the contacts were follow-up contacts with the CounterPart volunteers indicating that once engaged with the service many men and women continue to make contact. 38% of contacts were with women diagnosed with metastatic disease, a group who often have higher levels of unmet or more complex needs. 49% were born in a nonmain English speaking country (compared with the overall state of Victoria average of 19.6%) thus reflecting an accessible service to the non-English speaking community. What was learned: At a time when peer support is being increasingly recognized as a key part of effective supportive care in cancer services, the BOS program offers a model of integrated peer support that is respected, reliable, well supported and safe within the acute setting. This acute-community sector partnership demonstrates how the medical and social models of health care can work together to provide a connected and quality service for men and women diagnosed with breast cancer. An active research approach is enabling the project to be responsive to issues and challenges as they arise including the ongoing recruitment of women as volunteers from the local community to work within the acute setting.
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Hallinan, Christine M., and Kelsey L. Hegarty. "Advanced training for primary care and general practice nurses: enablers and outcomes of postgraduate education." Australian Journal of Primary Health 22, no. 2 (2016): 113. http://dx.doi.org/10.1071/py14072.
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The aims of the present study were to understand enablers to participation in postgraduate education for primary care nurses (PCNs), and to explore how postgraduate education has advanced their nursing practice. Cross-sectional questionnaires were mailed out in April 2012 to current and past students undertaking postgraduate studies in primary care nursing at The University of Melbourne, Victoria, Australia. Questionnaires were returned by 100 out of 243 nurses (response rate 41%). Ninety-one per cent (91/100) of the respondents were first registered as nurses in Australia. Fifty-seven per cent were hospital trained and 43% were university educated to attain their initial nurse qualification. The respondents reported opportunities to expand scope of practice (99%; 97/98), improve clinical practice (98%; 97/99), increase work satisfaction (93%; 91/98) and increase practice autonomy (92%; 89/97) as factors that most influenced participation in postgraduate education in primary care nursing. Major enablers for postgraduate studies were scholarship access (75%; 71/95) and access to distance education (74%; 72/98). Many respondents reported an increased scope of practice (98%; 95/97) and increased job satisfaction (71%; 70/98) as an education outcome. Only 29% (28/97) cited an increase in pay-rate as an outcome. Of the 73 PCNs currently working in general practice, many anticipated an increase in time spent on the preparation of chronic disease management plans (63%; 45/72), multidisciplinary care plans (56%; 40/72) and adult health checks (56%; 40/72) in the preceding 12 months. Recommendations emerging from findings include: (1) increased access to scholarships for nurses undertaking postgraduate education in primary care nursing is imperative; (2) alternative modes of course delivery need to be embedded in primary care nursing education; (3) the development of Australian primary care policy, including policy on funding models, needs to more accurately reflect the educational level of PCNs, PCN role expansion and the extent of interprofessional collaboration that is evident from research undertaken to date. Nurses with postgraduate education have the potential to increase their scope of practice, take on a greater teaching role and provide more preventive and chronic disease services in primary care. Policies aimed at increasing access to education for nurses working in primary care would strengthen the primary care nursing profession, and enhance the delivery of primary health care services in Australia.
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Petrass, Lauren A., Kate Simpson, Jenny Blitvich, Rhiannon Birch, and Bernadette Matthews. "Exploring the impact of a student-centred survival swimming programme for primary school students in Australia: the perceptions of parents, children and teachers." European Physical Education Review 27, no. 3 (February 3, 2021): 684–702. http://dx.doi.org/10.1177/1356336x20985880.
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Teaching basic swimming, water safety and rescue skills is recommended by the World Health Organization for all school-aged children. However, there is a lack of evidence on effective pedagogies to develop swimming competency and the success of swimming lessons as a drowning prevention intervention. This study used a self-report questionnaire and practical testing procedures to examine the effectiveness of a 10-week student-centred aquatic programme designed for children aged 10–12 years. The study also determined whether the non-traditional swimming programme was accepted by swim teachers, school teachers and principals, and parents from a range of schools from different geographical regions in Victoria, Australia. A total of 204 students were enrolled in the programme. The pre-programme results indicated a good level of swimming, water safety and aquatic knowledge, but low swimming ability. Swimming ability significantly improved from pre-programme to post-programme, with no significant post-programme ability differences between male and female children or for participants from different programmes. Qualitative feedback collected through questionnaires, interviews and/or focus groups from students ( n = 73) and parents ( n = 69), school teachers and principals ( n = 14), swim teachers and swim school managers ( n = 21) indicated strong support from principals and swim teachers for the student-centred pedagogy, and all stakeholders valued the focus on survival swimming competencies. This research highlights the importance of including stakeholders when designing and implementing aquatics programmes. The study has resulted in a well-founded, effective programme with tailored resources and instructional materials that are available for swim centres and schools that would enable schools globally to adopt and implement this programme.
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Dyson, Suzanne, Marian Pitts, Anthony Lyons, and Robyn Mullins. "Providing high quality information about human papillomavirus for women after treatment for high-grade cervical dysplasia." Sexual Health 7, no. 1 (2010): 49. http://dx.doi.org/10.1071/sh09059.
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Background: The present study aimed to inform the production of a resource for women who have had a high-grade cervical abnormality and are scheduled to undergo testing for human papillomavirus (HPV) at their 12-month follow-up. Methods: Two rounds of semi-structured, qualitative interviews were held with women who were attending a gynaecological oncology clinic at a major teaching hospital for women in Melbourne, Australia, 6 months after treatment for cervical intraepithelial neoplasia (CIN) to receive a follow-up Pap test and colposcopy. In an initial round of interviews, we gauged the reactions of 16 women to an existing information brochure containing general information about HPV. Based on the findings from the interviews, a second brochure aimed specifically for women scheduled to undergo HPV testing as part of their post treatment follow-up was drafted. Feedback was then gathered from a further 12 women. Results: While all participants had received some information and counselling about HPV and HPV testing as part of their treatment, many still experienced high levels of stress and anxiety about cancer and the sexually transmissible nature of HPV. Many also still had unanswered questions about HPV, their treatment regime and future prognosis. Conclusion: For a brochure to provide an effective adjunct to counselling, it is essential that it is carefully developed and pilot tested to ensure that it is easily understood and meets the information needs of the target audience. Such materials need to provide both medical and psychosocial information about HPV and be presented in accessible, easy to understand language.
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Borycki, Elizabeth M., Andre W. Kushniruk, Ryan Kletke, Vivian Vimarlund, Yalini Senathirajah, and Yuri Quintana. "Enhancing Safety During a Pandemic Using Virtual Care Remote Monitoring Technologies and UML Modeling." Yearbook of Medical Informatics 30, no. 01 (April 21, 2021): 264–71. http://dx.doi.org/10.1055/s-0041-1726485.
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Objectives: This paper describes a methodology for gathering requirements and early design of remote monitoring technology (RMT) for enhancing patient safety during pandemics using virtual care technologies. As pandemics such as COrona VIrus Disease (COVID-19) progress there is an increasing need for effective virtual care and RMT to support patient care while they are at home. Methods: The authors describe their work in conducting literature reviews by searching PubMed.gov and the grey literature for articles, and government websites with guidelines describing the signs and symptoms of COVID-19, as well as the progression of the disease. The reviews focused on identifying gaps where RMT could be applied in novel ways and formed the basis for the subsequent modelling of use cases for applying RMT described in this paper. Results: The work was conducted in the context of a new Home of the Future laboratory which has been set up at the University of Victoria. The literature review led to the development of a number of object-oriented models for deploying RMT. This modeling is being used for a number of purposes, including for education of students in health infomatics as well as testing of new use cases for RMT with industrial collaborators and projects within the smart home of the future laboratory. Conclusions: Object-oriented modeling, based on analysis of gaps in the literature, was found to be a useful approach for describing, communicating and teaching about potential new uses of RMT.
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Davis, M., L. Hochberg, R. Zetterberg, and V. Pridmore. "Can Cross-Sector Partnerships Increase Breast Cancer Screening in Hard-to-Reach Migrant Populations?" Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 142s. http://dx.doi.org/10.1200/jgo.18.20500.
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Background and context: BreastScreen Victoria (BSV) provides free breast screening to women aged 40+; targeting women aged 50-74. The program reduces breast cancer-related deaths by up to 28%. BSV aims to ensure equitable participation for all women in the target age; however there are large disparities in screening rates for different subpopulations. Emerging migrant women participate in breast screening at lower rates than the general population. These women face complex barriers including cultural factors, low health literacy, and access. BSV identified cross-sector partnerships, with local trusted organizations who engage with emerging migrant women, as an approach to tackle the multidimensional problems in screening inequalities. Aim: Through cross-sector partnerships BSV aims to bring together diverse skills, knowledge and resources for more effective health promotion outcomes, including: 1. Increasing awareness of breast screening in emerging migrant communities, 2. Providing a culturally safe environment for women to access breast screening. Strategy/Tactics: BSV partnered with organizations beyond the traditional health sector. One key partnership is with AMES Australia, who provide settlement services for refugees and migrants. The main approach of this model is two-way capacity building between organizations. BSV built the capacity of AMES to deliver BreastScreen's key messages, and promote screening to eligible women accessing their service. This included training for staff, resource development/sharing, and support. AMES built the capacity of BSV by providing insight into barriers for women they engage, and guidance adapting traditionally clinical environments ensuring cultural safety. To date BSV has undertaken screening initiatives with AMES in 2 Melbourne locations. Outcomes: - Migrant women are introduced to breast screening by a trusted organization - BSV's key messages are delivered in a culturally appropriate manner - Development of sustainable skills, structures and resources in both organizations - Utilization of AMES relationship with their clients to engage women who BSV may not reach -not on the Victorian Electoral Roll - 6 group bookings with specific languages groups - Familiar case worker and in person translator supporting group bookings - Engaging mainly first time screeners who may not have accessed a breast screen - Overcoming cultural, language, and health literacy barriers - Tailored appointments for groups and walk-ins. What was learned: A lack of tailored strategies to engage women in breast screening compounds barriers for migrant women. Cross-sector partnerships increase the efficiency of systems that impact health by making the best use of different but complementary resources. Collaborations, joint resourcing and planned action should be considered ongoing practice, particularly for disengaged populations, to address the many determinants of health that lie outside the reach of the health system.
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Testrow, Sean, Ryan McGovern, and Vicki Tully. "Secondary care interface: optimising communication between teams within secondary care to improve the rehabilitation journey for older people." BMJ Open Quality 10, no. 1 (February 2021): e001274. http://dx.doi.org/10.1136/bmjoq-2020-001274.
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Effective communication between members of the multidisciplinary team is imperative for patient safety. Within the Medicine for the Elderly wards at Royal Victoria Hospital (RVH) in Dundee, we identified an inefficient process of information-sharing between the orthopaedics outpatient department (OPD) at the main teaching hospital and our hospital’s rehabilitation teams, and sought to improve this by introducing several changes to the work system. Our aim was for all patients who attended the OPD clinic to have a plan communicated to the RVH team within 24 hours.Before our intervention, clinic letters containing important instructions for ongoing rehabilitation were dictated by the OPD team, transcribed and uploaded to an electronic system before the RVH team could access them. We analysed clinic attendances over a 4-week period and found that it took 15 days on average for letters to be shared with the RVH teams. We worked with both teams to develop a clinical communication tool and new processes, aiming to expedite the sharing of key information. Patients attended the OPD with this form, the clinician completed it at the time of their appointment and the form returned with the patient to RVH on the same day.We completed multiple Plan–Do–Study–Act cycles; before our project was curtailed by the COVID-19 pandemic. During our study period, seven patients attended the OPD with a form, with all seven returning to RVH with a completed treatment plan documented by the OPD clinician. This allowed rehabilitation teams to have access to clinic instructions generated by orthopaedic surgeons almost immediately after a patient attended the clinic, essentially eliminating the delay in information-sharing.The introduction of a simple communication tool and processes to ensure reliable transfer of information can expedite information-sharing between secondary care teams and can potentially reduce delays in rehabilitation.
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Barlow, John W., Andrea J. Curtis, Lorna E. Raggatt, Nicole M. Loidl, Duncan J. Topliss, and Jan R. Stockigt. "Drug competition for intracellular triiodothyronine-binding sites." European Journal of Endocrinology 130, no. 4 (April 1994): 417–21. http://dx.doi.org/10.1530/eje.0.1300417.
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Barlow JW, Curtis AJ, Raggatt LE, Loidl NM, Topliss DJ. Stockigt JR. Drug competition for intracellular triiodothyronine-binding sites. Eur J Endocrinol 1944;130:417–21. ISSN 0804–4643 A variety of substances, including frusemide, non-esterified fatty acids (NEFAs) and non-steroidal antiinflammatory drugs (NSAIDs), can compete for triiodothyronine (T3)-binding sites in serum and at the cell surface. We examined the competitive potency of these agents at intracellular T3-binding sites in order to assess their potential to act as T3 antagonists. Competition for [125I]T3 binding was determined using hydroxyapatite separation in cytosols and nuclear extracts prepared from livers of Macaca fascicularis. The T3 affinities were 15.8 ± 1.2 nmol/l in cytosol and 0.23 ± 0.02 nmol/l in nuclear extract. Does–response curves were analysed by a four-parameter sigmoid curve-fitting program to determine competitor potency. The nineteen agents tested included various NSAIDs, NEFAs, non-bile acid cholephils (NBACs), frusemide, amiodarone and the flavonoid EMD 21388. In nuclear extract the most active competitors were linoleic acid (8.5 μmol/l) and linolenic acid (7.8 μmol/l), Potencies of NSAIDs varied between 66 μmol/l (meclofenamic acid) and 525 μmol/l (diclofenac). In cytosol, NEFAs were less potent but NSAIDs were stronger competitors than in nuclear extract. Half-inhibitory potencies in cytosol were between 13.2 μmol/l (meclofenamic acid) and 63.1 μmol/l (flufenamic acid). The NBAC bromosulphthalein was one of the most potent inhibitors in both cytosol and nuclear extract. When expressed relative to T3, diclofenac was a more effective competitor in cytosol than it was in nuclear extract. Amiodarone and EMD 21388 were without effect both in cytosol and nuclear extract. Frusemide (759 μmol/l) was weakly active in cytosol only. The action of T3 was assessed by measuring secretion of sex hormone-binding globulin (SHBG) in Hep-G2 cells. After 3 days with total T3 (0.1 μmol/l), SHBG was 155 ± 15% of the control. Amiodarone (100 μmol/l) and meclofenamic acid (100 μmol/l) were cytotoxic. Bromosulphthalein (10 μmol/l), one of the most potent competitors at both the cytoplasmic and the nuclear level, did not influence the T3-induced rise in SHBG secretion. None of the drugs tested affected the magnitude of maximal induction of SHBG by T3. Substances that compete for serum and cell surface T3-binding sites are also weak competitors for intracellular T3-binding proteins, although the heirarchy of potency differs. Frusemide and diclofenac, with a greater relative potency for cytosolic binding than nuclear binding, may have potential use in investigating the function of cytosolic T3-binding. Amiodarone shows no binding activity and is not a hormone antagonist in primate hepatic tissue. John W Barlow, Ewen Downie Metabolic Unit, Alfred Hospital, Commercial Road, Melbourne, Victoria 3181, Australia