Digital Dexterity: A Sustainable Model for Building Essential Skills for the Future Workforce

The importance of digital dexterity in achieving institutional and business missions led the Council of Australian University Librarians (CAUL) to establish a Digital Dexterity Program in 2018. The aim of the CAUL Program was to ascertain the current state of play of digital literacies at member institutions and to establish best practice principles for developing the skills and understandings necessary for staff and students to become effective global citizens and lifelong learners. The Program consisted of three project teams tasked with developing resources that would provide: a framework for the development of digital dexterity skills, tools to assist CAUL members to improve their capability in digital dexterity, and a strategy and means to engage with stakeholders and advocate on digital dexterity. CAUL’s approach with the Digital Dexterity Program is unique in that it was practitioner-led, and involved industry engagement, particularly around the sustainability of the model. Each team consisted of CAUL member library staff with a passion for enabling and empowering staff and students through the development of digital dexterity skills. Team members were drawn from 14 institutions across six Australian states and territories and this collaborative work has enabled the development of a truly national approach. The grass-roots engagement included consultation with industry stakeholders outside of CAUL, including the Australian Academic and Research Network (AARNet), CAVAL and the Australian Research Data Commons. The Digital Dexterity Program, (launched in February 2019) included a Digital Dexterity Framework, and the establishment of a Community of Practice, which will ensure the continued development and sustainability of the program

Home enteral nutrition recipients: patient perspectives on training, complications and satisfaction

The equitable provision of home enteral nutrition (HEN) in the community can have a transformative effect on patient experience and family life for adults and children alike. While optimising quality of life in HEN patients can be challenging, the initiation of HEN positively impacts this measure of healthcare provision.1 Quality of life scores have been shown to improve in the weeks after hospital discharge, and HEN is physically well tolerated. However, it may be associated with psychological distress, and sometimes reluctance among HEN patients to leave their homes.2 Globally, HEN can attenuate cumulative projected patient care costs through a reduction in hospital admission and complications including hospital acquired infections.3 In an era where the cost of disease related malnutrition and associated prolonged hospital stay is being tackled in our healthcare systems, the role of HEN is set to expand. This is a treatment which has clear clinical and social benefits, and may restore some independence to patients and their families. Rather than the indications for HEN being focused on specific diagnoses, the provision of months of quality life at home for patients is adequate justification for its prescription.4 Previously, a review of HEN service provision in 39 cases demonstrated that patients want structured follow-up after hospital discharge, and in particular, would like one point of contact for HEN education and discharge.5 Management structures, funding challenges and the need for further education, particularly within the primary care setting may limit optimal use of HEN. The Irish Society for Clinical Nutrition and Metabolism (IrSPEN) aims to develop a national guideline document, drawing on international best practice, forming a template and standards for local policy development in the area of HEN service provision, training and follow-up. The first step in guideline development was to investigate patient experience for adults and children alike. Care needs and supports may differ in these distinct populations. The unmet needs of carers of older adults on HEN have been documented,6 although multidisciplinary interventions and evolution of standards for successful discharge will benefit all affected patients and their families. The aim of this study, therefore, was to survey domiciliary HEN clients, to document and analyse user experience, attitudes and complications associated with HEN

The Irish dual-energy X-ray absorptiometry (DXA) Health Informatics Prediction (HIP) for Osteoporosis Project

Purpose The purpose of the Irish dual-energy X-ray absorptiometry (DXA) Health Informatics Prediction (HIP) for Osteoporosis Project is to create a large retrospective cohort of adults in Ireland to examine the validity of DXA diagnostic classification, risk assessment tools and management strategies for osteoporosis and osteoporotic fractures for our population. Participants The cohort includes 36 590 men and women aged 4-104 years who had a DXA scan between January 2000 and November 2018 at one of 3 centres in the West of Ireland. Findings to date 36 590 patients had at least 1 DXA scan, 6868 (18.77%) had 2 scans and 3823 (10.45%) had 3 or more scans. There are 364 unique medical disorders, 186 unique medications and 46 DXA variables identified and available for analysis. The cohort includes 10 349 (28.3%) individuals who underwent a screening DXA scan without a clear fracture risk factor (other than age), and 9947 (27.2%) with prevalent fractures at 1 of 44 skeletal sites. Future plans The Irish DXA HIP Project plans to assess current diagnostic classification and risk prediction algorithms for osteoporosis and fractures, identify the risk predictors for osteoporosis and develop novel, accurate and personalised risk prediction tools, by using the large multicentre longitudinal follow-up cohort. Furthermore, the dataset may be used to assess, and possibly support, multimorbidity management due to the large number of variables collected in this project