'Online' geriatric assessment procedure for older adults referred for geriatric assessment during an acute care episode for consideration of reliability of triage decisions

Background Comprehensive geriatric assessment has been shown to improve patient outcomes, but the geriatricians who deliver it are in short-supply. A web-based method of comprehensive geriatric assessment has been developed with the potential to improve access to specialist geriatric expertise. The current study aims to test the reliability and safety of comprehensive geriatric assessment performed “online” in making geriatric triage decisions. It will also explore the accuracy of the procedure in identifying common geriatric syndromes, and its cost relative to conventional “live” consultations. Methods/Design The study population will consist of 270 acutely hospitalized patients referred for geriatric consultation at three sites. Paired assessments (live and online) will be conducted by independent, blinded geriatricians and the level of agreement examined. This will be compared with the level of agreement between two independent, blinded geriatricians each consulting with the patient in person (i.e. “live”). Agreement between the triage decision from live-live assessments and between the triage decision from live-online assessments will be calculated using kappa statistics. Agreement between the online and live detection of common geriatric syndromes will also be assessed using kappa statistics. Resource use data will be collected for online and live-live assessments to allow comparison between the two procedures. Discussion If the online approach is found to be less precise than live assessment, further analysis will seek to identify patient subgroups where disagreement is more likely. This may enable a protocol to be developed that avoids unsafe clinical decisions at a distance. Trial registration Trial registration number: ACTRN12611000936921

Assessing for work integrated learning experiences : a pre-service teacher perspective

A critical aspect of the debate about work integrated learning in the university context is the blurring of boundaries and responsibilities in terms of student learning. In an Australian pre-service teacher education program this blurring of boundaries is apparent in stakeholder tensions about the nature and role of assessment during the practicum. In the study reported in this paper, students responded positively to the content of assessment tasks but maintained that their efforts to implement the associated planning in the workplace were stymied because of disparate understandings between university and school staff about the purpose of the task.

Preservice practicum supervision : researching an on-line communication system

Practicum is widely recognised as an essential component of preservice professional teacher education. The effective supervision of preservice teachers while undertaking practicum is fundamental to the success of the field experience. However, many of the traditional models of supervision are under pressure. Alternative models for the supervision of preservice teacher practicum are needed to encourage stronger communication links between the university and field placement sites. This paper describes one such model, PracLink, an on-line communication infrastructure used to facilitate and support student learning during practicum. Research findings regarding the use of PracLink are reported, which highlight the strengths and potential of this model while also addressing its shortcomings.

Technology, design and process innovation in the built environment

Buildings and infrastructure represent principal assets of any national economy as well as prime sources of environmental degradation. Making them more sustainable represents a key challenge for the construction, planning and design industries and governments at all levels; and the rapid urbanisation of the 21st century has turned this into a global challenge. This book embodies the results of a major research programme by members of the Australia Co-operative Research Centre for Construction Innovation and its global partners, presented for an international audience of construction researchers, senior professionals and advanced students. It covers four themes, applied to regeneration as well as to new build, and within the overall theme of Innovation: Sustainable Materials and Manufactures, focusing on building material products, their manufacture and assembly – and the reduction of their ecological ‘fingerprints’, the extension of their service lives, and their re-use and recyclability. It also explores the prospects for applying the principles of the assembly line. Virtual Design, Construction and Management, viewed as increasing sustainable development through automation, enhanced collaboration (such as virtual design teams), real time BL performance assessment during design, simulation of the construction process, life-cycle management of project information (zero information loss) risk minimisation, and increased potential for innovation and value adding. Integrating Design, Construction and Facility Management over the Project Life Cycle, by converging ICT, design science engineering and sustainability science. Integration across spatial scales, enabling building–infrastructure synergies (such as water and energy efficiency). Convergences between IT and design and operational processes are also viewed as a key platform increased sustainability.

A hierarchical evolutionary algorithmic design (HEAD) system for generating and evolving building design models

This thesis develops a detailed conceptual design method and a system software architecture defined with a parametric and generative evolutionary design system to support an integrated interdisciplinary building design approach. The research recognises the need to shift design efforts toward the earliest phases of the design process to support crucial design decisions that have a substantial cost implication on the overall project budget. The overall motivation of the research is to improve the quality of designs produced at the author's employer, the General Directorate of Major Works (GDMW) of the Saudi Arabian Armed Forces. GDMW produces many buildings that have standard requirements, across a wide range of environmental and social circumstances. A rapid means of customising designs for local circumstances would have significant benefits. The research considers the use of evolutionary genetic algorithms in the design process and the ability to generate and assess a wider range of potential design solutions than a human could manage. This wider ranging assessment, during the early stages of the design process, means that the generated solutions will be more appropriate for the defined design problem. The research work proposes a design method and system that promotes a collaborative relationship between human creativity and the computer capability. The tectonic design approach is adopted as a process oriented design that values the process of design as much as the product. The aim is to connect the evolutionary systems to performance assessment applications, which are used as prioritised fitness functions. This will produce design solutions that respond to their environmental and function requirements. This integrated, interdisciplinary approach to design will produce solutions through a design process that considers and balances the requirements of all aspects of the design. Since this thesis covers a wide area of research material, 'methodological pluralism' approach was used, incorporating both prescriptive and descriptive research methods. Multiple models of research were combined and the overall research was undertaken following three main stages, conceptualisation, developmental and evaluation. The first two stages lay the foundations for the specification of the proposed system where key aspects of the system that have not previously been proven in the literature, were implemented to test the feasibility of the system. As a result of combining the existing knowledge in the area with the newlyverified key aspects of the proposed system, this research can form the base for a future software development project. The evaluation stage, which includes building the prototype system to test and evaluate the system performance based on the criteria defined in the earlier stage, is not within the scope this thesis. The research results in a conceptual design method and a proposed system software architecture. The proposed system is called the 'Hierarchical Evolutionary Algorithmic Design (HEAD) System'. The HEAD system has shown to be feasible through the initial illustrative paper-based simulation. The HEAD system consists of the two main components - 'Design Schema' and the 'Synthesis Algorithms'. The HEAD system reflects the major research contribution in the way it is conceptualised, while secondary contributions are achieved within the system components. The design schema provides constraints on the generation of designs, thus enabling the designer to create a wide range of potential designs that can then be analysed for desirable characteristics. The design schema supports the digital representation of the human creativity of designers into a dynamic design framework that can be encoded and then executed through the use of evolutionary genetic algorithms. The design schema incorporates 2D and 3D geometry and graph theory for space layout planning and building formation using the Lowest Common Design Denominator (LCDD) of a parameterised 2D module and a 3D structural module. This provides a bridge between the standard adjacency requirements and the evolutionary system. The use of graphs as an input to the evolutionary algorithm supports the introduction of constraints in a way that is not supported by standard evolutionary techniques. The process of design synthesis is guided as a higher level description of the building that supports geometrical constraints. The Synthesis Algorithms component analyses designs at four levels, 'Room', 'Layout', 'Building' and 'Optimisation'. At each level multiple fitness functions are embedded into the genetic algorithm to target the specific requirements of the relevant decomposed part of the design problem. Decomposing the design problem to allow for the design requirements of each level to be dealt with separately and then reassembling them in a bottom up approach reduces the generation of non-viable solutions through constraining the options available at the next higher level. The iterative approach, in exploring the range of design solutions through modification of the design schema as the understanding of the design problem improves, assists in identifying conflicts in the design requirements. Additionally, the hierarchical set-up allows the embedding of multiple fitness functions into the genetic algorithm, each relevant to a specific level. This supports an integrated multi-level, multi-disciplinary approach. The HEAD system promotes a collaborative relationship between human creativity and the computer capability. The design schema component, as the input to the procedural algorithms, enables the encoding of certain aspects of the designer's subjective creativity. By focusing on finding solutions for the relevant sub-problems at the appropriate levels of detail, the hierarchical nature of the system assist in the design decision-making process.

Ensuring student success : establishing a community of practice for culturally and linguistically diverse preservice teachers

This paper discusses the primacy of communities of practice within learning contexts at university and during practicum for culturally and linguistically diverse preservice teachers. The study illustrates that learning occurs when there are adequate opportunities for participation and practice. Data from interviews with 28 culturally and linguistically diverse preservice teachers illustrate that tensions created by social, cultural differences impact upon modes of identification and dimensions of practice (Lave & Wenger, 1991; Wenger, 1998). The study concludes by reiterating the importance of establishing proactive communities of practice to ensure success in learning and practice for this group of preservice teachers.

Pre-service Physical Education teachers and concerns regarding their ability to successfully facilitate school-based physical activity promotion strategies

Regular physical activity (PA) in youth has numerous immediate and long-term health benefits. With several studies indicating low levels of youth PA globally, schools settings have become increasingly critical settings for youth health promotion strategies. The role of physical education (PE) teachers has long been considered central to the facilitation of such strategies. However, PE teachers have a selfreported lack of knowledge, skills, understanding, and competence to successfully implement these strategies. Tertiary education programs are fundamental to adequately preparing, and shaping the attitudes and philosophies of future PE teachers towards their involvement within these programs. The aim of this investigation was to explore the beliefs and perceptions of future secondary school PE teachers, regarding their potential roles in future school-based programs designed to promote student PA. Fifty-seven (21 males and 36 females) pre-service PE teachers completed a series of open-ended survey questions concerning their perceptions towards participating in school-based PA promotion programs both as preservice during practicum, and prospectively as practising teachers. Responses were analysed thematically. Participants responded both positively and enthusiastically to both questions. Concerns regarding time, and the intention or expectation to participate in such programs were also key themes for pre-service and practicing teacher participation respectively. Critically in this study, participants did not identify any limitations which may impact upon their ability to successfully promote youth PA in school settings. This may indicate that participants have misconceptions regarding their ability to fulfil this role, or conversely, the deficiency of current PE teachers regarding school-based PA promotion has been recognised by the tertiary institution, and addressed to adequately prepare its students. School-based PA promotion is an integral element of pre-service PE teacher education, and ongoing professional development of practicing PE teachers. This trend is expected to continue in the future, in order to address ongoing public health concerns.

Feedback consistencies and inconsistencies : eight mentors’ observations on one preservice teacher’s lesson

Mentors play a key role in developing preservice teachers for their chosen careers and providing feedback appears as a significant relational interaction between the mentor and mentee that assists in guiding the mentee’s practices. Yet, what are mentors’ perspectives on providing feedback to their mentees? In this case study, eight mentors viewed a professional video recorded science lesson facilitated by a final-year preservice teacher during practicum for the purposes of providing oral feedback in a simulated mentor-mentee discussion. Findings showed that mentors’ feedback was variable in both their positive feedback and constructive criticisms and, in one case, the feedback was contrasting in nature. Implications are discussed, including preservice teachers receiving feedback from more than one mentor and universities researching the design of valid and reliable tools to guide mentors’ oral feedback.

Planning to Manage My Teaching in a Democratic Classroom

Preservice teachers consistently report that managing student behaviour is one of their major concerns prior to and during practicum (Capel, 1997; Kyriacou & Stephens, 1999). Not surprisingly, preservice teachers are keen to gain knowledge and understanding of effective classroom management approaches that facilitate the development of positive learning environments in which students are engaged in learning. Establishing democratic teaching practices that allow student choice, communicating in a positive, helpful manner, ensuring the right to teach and the right to learn without disruptions is upheld, and promoting self-discipline are important steps in preventing misbehavior and developing a democratic community of learners.

Assessment of police subjective workload and preference for using a voice-based interface during simulated driving

Police in-vehicle systems include a visual output mobile data terminal (MDT) with manual input via touch screen and keyboard. This study investigated the potential for voice-based input and output modalities for reducing subjective workload of police officers while driving. Nineteen experienced drivers of police vehicles (one female) from New South Wales (NSW) Police completed four simulated urban drives. Three drives included a concurrent secondary task: an imitation licence number search using an emulated MDT. Three different interface output-input modalities were examined: Visual-Manual, Visual-Voice, and Audio-Voice. Following each drive, participants rated their subjective workload using the NASA - Raw Task Load Index and completed questions on acceptability. A questionnaire on interface preferences was completed by participants at the end of their session. Engaging in secondary tasks while driving significantly increased subjective workload. The Visual-Manual interface resulted in higher time demand than either of the voice-based interfaces and greater physical demand than the Audio-Voice interface. The Visual-Voice and Audio-Voice interfaces were rated easier to use and more useful than the Visual-Manual interface, although not significantly different from each other. Findings largely echoed those deriving from the analysis of the objective driving performance data. It is acknowledged that under standard procedures, officers should not drive while performing tasks concurrently with certain invehicle policing systems; however, in practice this sometimes occurs. Taking action now to develop voice-based technology for police in-vehicle systems has potential to realise visions for potentially safer and more efficient vehicle-based police work.

Automated fit assessment of intramedullary nail designs during insertion

Modern intramedullary nails, which are utilised for the treatment of bone fractures, need to be designed to fit the anatomy of the patient population. Traditional and recent semi-automated approaches for quantifying the anatomical fit between bones and nail designs suffer from various drawbacks. This thesis proposed an automated comprehensive nail design validation method. The developed software tool was utilised to quantify the anatomical fit of four commercial nail designs. Furthermore, the thesis demonstrated the existence of a bone-nail specific nail entry point. The developed method is of great benefit for the implant manufacturing industry as a nail design validation tool.

Integrating eco-efficiency assessment of commercial buildings into the design process : LCADesign

The ability to assess a commercial building for its impact on the environment at the earliest stage of design is a goal which is achievable by integrating several approaches into a single procedure directly from the 3D CAD representation. Such an approach enables building design professionals to make informed decisions on the environmental impact of building and its alternatives during the design development stage instead of at the post-design stage where options become limited. The indicators of interest are those which relate to consumption of resources and energy, contributions to pollution of air, water and soil, and impacts on the health and wellbeing of people in the built environment as a result of constructing and operating buildings. 3D object-oriented CAD files contain a wealth of building information which can be interrogated for details required for analysis of the performance of a design. The quantities of all components in the building can be automatically obtained from the 3D CAD objects and their constituent materials identified to calculate a complete list of the amounts of all building products such as concrete, steel, timber, plastic etc. When this information is combined with a life cycle inventory database, key internationally recognised environmental indicators can be estimated. Such a fully integrated tool known as LCADesign has been created for automated ecoefficiency assessment of commercial buildings direct from 3D CAD. This paper outlines the key features of LCADesign and its application to environmental assessment of commercial buildings.

Redefining life cycle for a building sustainability assessment framework

Understanding the differences between the temporal and physical aspects of the building life cycle is an essential ingredient in the development of Building Environmental Assessment (BEA) tools. This paper illustrates a theoretical Life Cycle Assessment (LCA) framework aligning temporal decision-making with that of material flows over building development phases. It was derived during development of a prototype commercial building design tool that was based on a 3-D CAD information and communications technology (ICT) platform and LCA software. The framework aligns stakeholder BEA needs and the decision-making process against characteristics of leading green building tools. The paper explores related integration of BEA tool development applications on such ICT platforms. Key framework modules are depicted and practical examples for BEA are provided for: • Definition of investment and service goals at project initiation; • Design integrated to avoid overlaps/confusion over the project life cycle; • Detailing the supply chain considering building life cycle impacts; • Delivery of quality metrics for occupancy post-construction/handover; • Deconstruction profiling at end of life to facilitate recovery.