Development and validation of a novel approach to work sampling : a study of nurse practitioner work patterns

Objectives: This methodological paper reports on the development and validation of a work sampling instrument and data collection processes to conduct a national study of nurse practitioners’ work patterns. ---------- Design: Published work sampling instruments provided the basis for development and validation of a tool for use in a national study of nurse practitioner work activities across diverse contextual and clinical service models. Steps taken in the approach included design of a nurse practitioner-specific data collection tool and development of an innovative web-based program to train and establish inter rater reliability of a team of data collectors who were geographically dispersed across metropolitan, rural and remote health care settings. ---------- Setting: The study is part of a large funded study into nurse practitioner service. The Australian Nurse Practitioner Study is a national study phased over three years and was designed to provide essential information for Australian health service planners, regulators and consumer groups on the profile, process and outcome of nurse practitioner service. ---------- Results: The outcome if this phase of the study is empirically tested instruments, process and training materials for use in an international context by investigators interested in conducting a national study of nurse practitioner work practices. ---------- Conclusion: Development and preparation of a new approach to describing nurse practitioner practices using work sampling methods provides the groundwork for international collaboration in evaluation of nurse practitioner service.

The work of nurse practitioners : a national work sampling study

Aim: This paper is a report of a study of variations in the pattern of nurse practitioner work in a range of service fields and geographical locations, across direct patient care, indirect patient care and service-related activities. Background. The nurse practitioner role has been implemented internationally as a service reform model to improve the access and timeliness of health care. There is a substantial body of research into the nurse practitioner role and service outcomes, but scant information on the pattern of nurse practitioner work and how this is influenced by different service models. --------- Methods: We used work sampling methods. Data were collected between July 2008 and January 2009. Observations were recorded from a random sample of 30 nurse practitioners at 10-minute intervals in 2-hour blocks randomly generated to cover two weeks of work time from a sampling frame of six weeks. --------- Results: A total of 12,189 individual observations were conducted with nurse practitioners across Australia. Thirty individual activities were identified as describing nurse practitioner work, and these were distributed across three categories. Direct care accounted for 36.1% of how nurse practitioners spend their time, indirect care accounted for 32.2% and service-related activities made up 31.9%. --------- Conclusion. These findings provide useful baseline data for evaluation of nurse practitioner positions and the service effect of these positions. However, the study also raises questions about the best use of nurse practitioner time and the influences of barriers to and facilitators of this model of service innovation.

Work-related driving safety in light vehicle fleets : a review of past research and the development of an intervention framework

This paper presents a critical review of past research in the work-related driving field in light vehicle fleets (e.g., vehicles < 4.5 tonnes) and an intervention framework that provides future direction for practitioners and researchers. Although work-related driving crashes have become the most common cause of death, injury, and absence from work in Australia and overseas, very limited research has progressed in establishing effective strategies to improve safety outcomes. In particular, the majority of past research has been data-driven, and therefore, limited attention has been given to theoretical development in establishing the behavioural mechanism underlying driving behaviour. As such, this paper argues that to move forward in the field of work-related driving safety, practitioners and researchers need to gain a better understanding of the individual and organisational factors influencing safety through adopting relevant theoretical frameworks, which in turn will inform the development of specifically targeted theory-driven interventions. This paper presents an intervention framework that is based on relevant theoretical frameworks and sound methodological design, incorporating interventions that can be directed at the appropriate level, individual and driving target group.

Optimal track access rights allocation for agent negotiation in an open railway market

In open railway access markets, a train service provider (TSP) negotiates with an infrastructure provider (IP) for track access rights. This negotiation has been modeled by a multi-agent system (MAS) in which the IP and TSP are represented by separate software agents. One task of the IP agent is to generate feasible (and preferably optimal) track access rights, subject to the constraints submitted by the TSP agent. This paper formulates an IP-TSP transaction and proposes a branch-and-bound algorithm for the IP agent to identify the optimal track access rights. Empirical simulation results show that the model is able to emulate rational agent behaviors. The simulation results also show good consistency between timetables attained from the proposed methods and those derived by the scheduling principles adopted in practice.

Work integrated learning as a component of the capstone experience in undergraduate law

Background: The “Curriculum renewal in legal education” project has been funded by the Australian Learning and Teaching Council with the core objectives being the articulation of a set of final year curriculum design principles, and the development of a model of a transferable final year program. Through these principles and the development of the model, it is anticipated that the final year experience for law students will provide greater opportunity for them to understand the relevance of their learning, and will enhance their capacity to make decisions regarding their career path. Discussion / Argument: This paper reports on the project’s progress to date, and presents an argument for the inclusion of work integrated learning (WIL) as a component of the final year experience in undergraduate law programs. The project has identified that the two principal objectives of capstone experiences are to provide closure and to facilitate transition to post-university life. Reflective practice and Bruner’s spiral curriculum model are the central theoretical foundations by which these objectives can be achieved. Experiential learning is also increasingly seen as an essential element of a capstone experience. WIL is consistent with the objectives of capstones in focusing on the transition to professional practice and providing opportunities for reflection. However, the ability of WIL to meet all of the objectives of capstones, particularly closure and integration, may be limited. Conclusions / Implications: The paper posits that while WIL should be considered as a potential component of a capstone experience, educators should ensure that WIL is not equated with a capstone experience unless it is carefully designed to ensure that all of the objectives of capstones are met. Keywords: Work-integrated learning, capstone, final year experience, law

Using poster presentations as assessment of work integrated learning

Background / context: The ALTC WIL Scoping Study identified a need to develop innovative assessment methods for work integrated learning (WIL) that encourage reflection and integration of theory and practice within the constraints that result from the level of engagement of workplace supervisors and the ability of academic supervisors to become involved in the workplace. Aims: The aim of this paper is to examine how poster presentations can be used to authentically assess student learning during WIL. Method / Approach: The paper uses a case study approach to evaluate the use of poster presentations for assessment in two internship units at the Queensland University of Technology. The first is a unit in the Faculty of Business where students majoring in advertising, marketing and public relations are placed in a variety of organisations. The second unit is a law unit where students complete placements in government legal offices. Results / Discussion: While poster presentations are commonly used for assessment in the sciences, they are an innovative approach to assessment in the humanities. This paper argues that posters are one way that universities can overcome the substantial challenges of assessing work integrated learning. The two units involved in the case study adopt different approaches to the poster assessment; the Business unit is non-graded and the poster assessment task requires students to reflect on their learning during the internship. The Law unit is graded and requires students to present on a research topic that relates to their internship. In both units the posters were presented during a poster showcase which was attended by students, workplace supervisors and members of faculty. The paper evaluates the benefits of poster presentations for students, workplace supervisors and faculty and proposes some criteria for poster assessment in WIL. Conclusions / Implications: The paper concludes that posters can effectively and authentically assess various learning outcomes in WIL in different disciplines while at the same time offering a means to engage workplace supervisors with academic staff and other students and supervisors participating in the unit. Posters have the ability to demonstrate reflection in learning and are an excellent demonstration of experiential learning and assessing authentically. Keywords: Work integrated learning, assessment, poster presentations, industry engagement.

The nonconceptual gateway to early word learning

My research investigates why nouns are learned disproportionately more frequently than other kinds of words during early language acquisition (Gentner, 1982; Gleitman, et al., 2004). This question must be considered in the context of cognitive development in general. Infants have two major streams of environmental information to make meaningful: perceptual and linguistic. Perceptual information flows in from the senses and is processed into symbolic representations by the primitive language of thought (Fodor, 1975). These symbolic representations are then linked to linguistic input to enable language comprehension and ultimately production. Yet, how exactly does perceptual information become conceptualized? Although this question is difficult, there has been progress. One way that children might have an easier job is if they have structures that simplify the data. Thus, if particular sorts of perceptual information could be separated from the mass of input, then it would be easier for children to refer to those specific things when learning words (Spelke, 1990; Pylyshyn, 2003). It would be easier still, if linguistic input was segmented in predictable ways (Gentner, 1982; Gleitman, et al., 2004) Unfortunately the frequency of patterns in lexical or grammatical input cannot explain the cross-cultural and cross-linguistic tendency to favor nouns over verbs and predicates. There are three examples of this failure: 1) a wide variety of nouns are uttered less frequently than a smaller number of verbs and yet are learnt far more easily (Gentner, 1982); 2) word order and morphological transparency offer no insight when you contrast the sentence structures and word inflections of different languages (Slobin, 1973) and 3) particular language teaching behaviors (e.g. pointing at objects and repeating names for them) have little impact on children's tendency to prefer concrete nouns in their first fifty words (Newport, et al., 1977). Although the linguistic solution appears problematic, there has been increasing evidence that the early visual system does indeed segment perceptual information in specific ways before the conscious mind begins to intervene (Pylyshyn, 2003). I argue that nouns are easier to learn because their referents directly connect with innate features of the perceptual faculty. This hypothesis stems from work done on visual indexes by Zenon Pylyshyn (2001, 2003). Pylyshyn argues that the early visual system (the architecture of the "vision module") segments perceptual data into pre-conceptual proto-objects called FINSTs. FINSTs typically correspond to physical things such as Spelke objects (Spelke, 1990). Hence, before conceptualization, visual objects are picked out by the perceptual system demonstratively, like a finger pointing indicating ‘this’ or ‘that’. I suggest that this primitive system of demonstration elaborates on Gareth Evan's (1982) theory of nonconceptual content. Nouns are learnt first because their referents attract demonstrative visual indexes. This theory also explains why infants less often name stationary objects such as plate or table, but do name things that attract the focal attention of the early visual system, i.e., small objects that move, such as ‘dog’ or ‘ball’. This view leaves open the question how blind children learn words for visible objects and why children learn category nouns (e.g. 'dog'), rather than proper nouns (e.g. 'Fido') or higher taxonomic distinctions (e.g. 'animal').

Axial elongation following prolonged near work in myopes and emmetropes

Background/aims: To investigate the influence of a period of sustained near work upon axial length in groups of emmetropes and myopes. Methods: Forty young adult subjects (20 myopes and 20 emmetropes) were recruited for the study. Myopes were further classified as either early onset (EOM), late onset (LOM), stable (SM) or progressing (PM) subgroups. Axial length was measured with the IOLMaster instrument before, immediately after and then again 10 minutes after a continuous 30 minute near task of 5 D accommodation demand. Measures of distance objective refraction were also collected. Results: Significant changes in axial length were observed immediately following the near task. EOM axial length elongated on average by 0.027 ± 0.021 mm, LOM by 0.014 ± 0.020 mm, EMM by 0.010 ± 0.015 mm, PM by 0.031 ± 0.022 mm, and SM by 0.014 ± 0.018 mm. At the conclusion of the 10 minute regression period, axial length measures were not significantly different from baseline values. Conclusion: Axial elongation was observed following a prolonged near task. Both EOM and PM groups showed increases in axial length that were significantly greater than emmetropes

Education-to-work transitions of aspiring creatives

Despite some segments of the creative industries in Australia performing better than other segments in terms of earnings and employment growth, they all rely on highly skilled workers and face similar workforce challenges. Workers typically experience multiple entry attempts, spells of unemployment, short-term contracts, high degrees of mobility, casual/part-time employment within and outside the creative industries, and pressure to ensure their skills remain relevant. Skills shortages and gaps, an insufficient supply of high quality industry-ready graduates, difficulties in predicting demand for skills, weak linkages between industry and education providers, reliance on overseas talent in some segments, limited opportunities for workers to engage in skill development, and pressure on workers to keep abreast of technological developments are ongoing issues in the creative industries workforce. In response to these concerns, the Australian Research Council, three State Governments, industry, and a large vocational education and training (VET) provider funded Queensland University of Technology (QUT) to conduct the 60Sox project. This three-year project investigated the education, training, and work experiences of aspiring creatives defined as new entrants, recent graduates, and students enrolled in creative industries courses. It involved the largest survey of aspiring creatives ever undertaken in Australia, attracting 507 respondents, and a survey of 50 employers. Using the framework proposed by Hannan, Raffe, and Smyth (1996), this article presents findings from an analysis of the macro and micro labour market outcomes of aspiring creatives using data from the two 60Sox project surveys and publicly available sources. The analysis confirmed that many graduates of creative industries courses who participated in the 60Sox survey and the national surveys for the National Centre for Vocational Education Research and Graduate Careers Australia were struggling to make a successful transition from education to work. This article also discusses the causes of this key finding and possible solutions to address transition issues.

Knowledge and attitudes about Vitamin D and impact on sun protection practices among urban office workers in Brisbane, Australia

Background: Sun exposure is the main source of vitamin D. Increasing scientific and media attention to the potential health benefits of sun exposure may lead to changes in sun exposure behaviors. Methods: To provide data that might help frame public health messages, we conducted an online survey among office workers in Brisbane, Australia, to determine knowledge and attitudes about vitamin D and associations of these with sun protection practices. Of the 4,709 people invited to participate, 2,867 (61%) completed the questionnaire. This analysis included 1,971 (69%) participants who indicated that they had heard about vitamin D. Results: Lack of knowledge about vitamin D was apparent. Eighteen percent of people were unaware of the bone benefits of vitamin D but 40% listed currently unconfirmed benefits. Over half of the participants indicated that more than 10 minutes in the sun was needed to attain enough vitamin D in summer, and 28% indicated more than 20 minutes in winter. This was significantly associated with increased time outdoors and decreased sunscreen use. People believing sun protection might cause vitamin D deficiency (11%) were less likely to be frequent sunscreen users (summer odds ratio, 0.63; 95% confidence interval, 0.52-0.75). Conclusions: Our findings suggest that there is some confusion about sun exposure and vitamin D, and that this may result in reduced sun-protective behavior. Impact: More information is needed about vitamin D production in the skin. In the interim, education campaigns need to specifically address the vitamin D issue to ensure that skin cancer incidence does not increase.

Talking the talk and walking the walk : how managers can influence the quality of work-life balance in a construction project

Purpose – The construction industry in Australia is characterised by a long work-hours culture, with conditions that make it difficult for staff to balance their work and non-work lives. The objective of this paper is to measure the success of a work-place intervention designed to improve work-life balance (WLB) in an alliance project in the construction industry, and the role the project manager plays in this success. Design/methodology/approach – The paper focuses on an alliance case study. Interviews were conducted at two points in time, several months apart, after the interventions were implemented. Findings – Results showed that staff on the whole were more satisfied with their work experience after the interventions, and indicated the important role that managers' attitudes and behaviours played. Originality/value – Managerial support for work-life initiatives is a critical element in achieving WLB and satisfaction with working arrangements. The fact that the manager “talked the talk and walked the walk” was a major contributing success factor, which has not previously been demonstrated.

Multiple Health Behavior Changes and Co-variation in a Telephone Counseling Trial

Background Delivering effective multiple health behavior interventions to large numbers of adults with chronic conditions via primary care settings is a public health priority. Purpose Within a 12-month, telephone-delivered diet and physical activity intervention with multiple behavioral outcomes, we examined the extent and co-variation of multiple health behavior change. Methods A cluster-randomized trial with 434 patients with type 2 diabetes or hypertension were recruited from 10 general practices, which were randomized to receive telephone counseling or usual care. Results Those receiving telephone counseling were significantly more likely than those in usual care to make greater reductions in multiple behaviors after adjusting for baseline risk behaviors (OR 2.42; 95%CI 1.43, 4.11). Controlling for baseline risk and group allocation, making changes to either physical activity, fat, vegetable, or fiber intake was associated with making significantly more improvements in other behaviors. Conclusions For patients with chronic conditions, telephone counseling can significantly improve multiple health behaviors, with behavioral changes tending to co-vary.

Factors that affect health outcomes in adults with type 2 diabetes : a cross-sectional study

Background: Factors that individually influence blood sugar control, health-related quality of life, and diabetes self-care behaviors have been widely investigated; however, most previous diabetes studies have not tested an integrated association between a series of factors and multiple health outcomes. ---------- Objectives: The purposes of this study are to identify risk factors and protective factors and to examine the impact of risk factors and protective factors on adaptive outcomes in people with type 2 diabetes.---------- Design: A descriptive correlational design was used to examine a theoretical model of risk factors, protective factors, and adaptive outcomes.---------- Settings: This study was conducted at the endocrine outpatient departments of three hospitals in Taiwan. Participants A convenience sample of 334 adults with type 2 diabetes aged 40 and over.---------- Methods: Data were collected by a self-reported questionnaire and physiological examination. Using the structural equation modeling technique, measurement and structural regression models were tested.---------- Results: Age and life events reflected the construct of risk factors. The construct of protective factors was explained by diabetes symptoms, coping strategy, and social support. The construct of adaptive outcomes comprised HbA1c, health-related quality of life, and self-care behaviors. Protective factors had a significant direct effect on adaptive outcomes (β = 0.68, p < 0.001); however, risk factors did not predict adaptive outcomes (β = − 0.48, p = 0.118).---------- Conclusions: Identifying and managing risk factors and protective factors are an integral part of diabetes care. This theoretical model provides a better understanding of how risk factors and protective factors work together to influence multiple adaptive outcomes in people living with type 2 diabetes.