Flinders Clinical Effectiveness - Collected Works

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Now showing 1 - 6 of 12
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    The implementation of intentional rounding using participatory action research
    (Wiley Publishing Asia Pty Ltd, 2013-07-08) Harrington, Ann Chrystine ; Bradley, Sandra L ; Jeffers, Lesley ; Linedale, Ecushla ; Kelman, Sue ; Killington, Geoffrey
    ‘Intentional’/’hourly rounding’ is defined as regular checks of individual patients carried out by health professionals at set intervals, rather than a response to a summons via a call bell. Intentional rounding places patients at the heart of the ward routine including the acknowledgement of patient preferences and in anticipation of their needs. The aim of this study was to implement intentional rounding using Participatory Action Research to increase patient care, increase staff productivity and the satisfaction of care provision from both patients and staff. Outcomes of the study revealed a drop in call bell use, no observable threats to patient safety, nursing staff and patient satisfaction with care provision. However, any future studies should consider staff skill mix issues, including the needs of newly graduated nursing staff as well as the cognitive status of patients when implementing intentional rounding on acute care wards.
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    Current Advance Directive Use in South Australia: Results from the 2012 Spring South Australian Health Omnibus Survey
    (BMJ Publishing Group, 2013) Bradley, Sandra L ; Woodman, Richard John ; Phillips, Paddy Andrew ; Tieman, Jennifer
    Background: Advance directives enable autonomous decision-making for future healthcare and welfare and are an integral part of many advance care planning programs. Current evidence of use of these instruments in South Australia (SA) is presented. Aim: To ascertain the prevalence and type of advance directives used in SA. Methods: Questions exploring the prevalence and type of advance directives experienced by the South Australian public were submitted to the Spring South Australian Health Omnibus Survey (HOS) 2012. The HOS has been conducted regularly since 1991 and is used by government and nongovernment organisations to assess the healthcare needs of the South Australian community. The survey comprises a random sample of 3000 members of the public drawn in a multi-stage, systematic sampling technique*. Results: Analysis of data yielded demographic and sociological characteristics such as age, gender, and education as well as: prevalence and type of advance directive completed; engagement with family or friends to complete advance directives; and substitute decision-making agency. Discussion: Using the HOS survey enabled analysis of demographic and sociological characteristics of the SA public with prevalence and type of advance directives experienced and provided evidence-based knowledge of the public’s engagement in autonomous decision-making for future healthcare and welfare. Conclusion: Accurate ascertainment of the South Australian public’s current levels of knowledge and engagement with advance directives can assist future advance care planning initiatives in South Australia as well as provide a basis for further research designed to enhance completion rates of these instruments by the general public.
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    Use of advance directives by South Australians: Results from the Health Ominbus Survey Spring 2012.
    (Australasian Medical Publishing Company Ltd, 2014) Bradley, Sandra L ; Woodman, Richard John ; Tieman, Jennifer ; Phillips, Paddy Andrew
    Objective: To determine the prevalence of completion of advance directives (ADs) and wills by South Australians aged 15 years and over. Design, setting and participants: Statewide population-based survey of a single member (aged 15 years and over) of 3055 South Australian households between 4 September and 12 December 2012. Main outcome measures: Prevalence and sociodemographic determinants of completion of the four recognised legal ADs in South Australia (enduring power of attorney [EPA] for finance, enduring power of guardianship [EPG] for health care/lifestyle, medical power of attorney [MPA] for medical treatment and anticipatory direction for end-of-life care) and wills. Results: Nearly half the 3055 survey participants had not completed any AD document or will. Financial documents were more likely to be completed than health care documents. In multivariate analysis, the odds of not having completed any AD was higher among those aged 15–24 years compared with those aged over 65 years (odds ratio [OR], 55.3; 95% CI, 31.3–97.7) and 25–44 years (OR, 24.9; 95% CI, 17.3–36.1). Similarly, the odds were higher for those born in another country (OR, 2.0; 95% CI, 1.6–2.4); those never married (OR, 3.1; 95% CI, 2.3–4.2) or in de facto relationships (OR, 2.8; 95% CI, 2.1–3.8) or separated/divorced (OR, 1.8; 85% CI, 1.3–2.4) compared with those married; those who left school in Year 12 or before (OR, 1.5; 95% CI, 1.1–1.9) or with a bachelor degree (OR, 1.5; 95% CI, 1.1–2.0) compared with those who had completed a trade/apprenticeship, certificate/diploma; and those in blue collar occupations (OR 1.6; 95% CI, 1.3–2.2) or not employed (OR, 2.2; 95% CI, 1.4–3.6) versus professionals. The odds of not having completed any AD were lower for those living in rural or regional areas (OR, 0.8, 95% CI, 0.6–1.0) compared with the metropolitan area, and for those in the highest income bracket earning more than $80 000 (OR, 0.6; 95% CI, 0.5–0.8) compared with those in the middle bracket earning $40 000–$80 000. Conclusion: Completion rates of ADs among South Australians remain low, with financial instruments more likely to be completed than health care and lifestyle instruments. The odds of not completing ADs were associated with age and socioeconomic characteristics. General practitioners are in a good position to target advance care planning towards relevant patient groups, which would likely improve rates of decision making in future health care.
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    Dilemmas in assessing performance on fieldwork education placements
    (Sense Publishers, 2010) McAllister, Sue Margery ; Lincoln, Michelle ; Ferguson, Alison ; McAllister, Lindy
    Our students value fieldwork placements and their fieldwork educators highly. They enter our university programs with the goal of joining us in our practice. Competency-based assessment based on observed performance of students in the real world of the workplace is highly authentic and motivating for all. As described in this chapter, this assessment practice raises a number of dilemmas, many of which are common with any kind of assessment. However, valid and reliable competency-based assessments with positive impacts upon learning can be developed through careful thought and attention to the processes and content required to support fieldwork educators' judgments and the students' learning.
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    Checklist of parent Lidcombe Program administration
    (Speech Pathology Australia, 2012) Swift, Michelle Catherine ; O'Brian, Sue ; Onslow, Mark ; Packman, Ann
    This article outlines the development of a checklist to document parent and child behaviours when implementing Lidcombe Program treatment during structured conversations. We present item development and reliability testing and instructions for use by speech pathologists. Finally, we present two case studies to demonstrate use of the checklist to aid clinical decision-making during Lidcombe Program treatment.
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    Estrogen defines the dynamics and destination of transactivated EGF receptor in breast cancer cells: role of S1P3 receptor and Cdc42
    (Elsevier, 2013-02-15) Sukocheva, Olga Anatolyevna ; Wadham, Carol ; Xia, Pu
    Sphingosine-1-phosphate (S1P) receptors mediate transactivation of epidermal growth factor receptor (EGFR) by estrogen (E2). Here we report that the amount of intracellular EGFR remains elevated after stimulation of MCF-7 cells with E2 and S1P, although membrane-localized EGFR and S1P3 receptors are quickly internalized. Co-localization of internalized EGFR and LAMP-2 was lower in cells treated with E2/S1P, suggesting that endosomal EGFR might be directed for recycling instead of degradation. In addition, we found that E2/S1P activated Cdc42 and that knockdown of Cdc42 restores fast EGFR degradation after E2/S1P stimulation. Inhibition of S1P3 receptors prevented E2-induced activation of Cdc42, supporting the important role of the S1P receptor in E2 signaling. This is a novel mechanism further defining the effect of E2/S1P on the EGFR transactivation in breast cancer cells.