Extending client-centered support : counselors’ proposals to shift from email to telephone counseling

The availability and use of online counseling approaches has increased rapidly over the last decade. While research has suggested a range of potential affordances and limitations of online counseling modalities, very few studies have offered detailed examinations of how counselors and clients manage asynchronous email counseling exchanges. In this paper we examine email exchanges involving clients and counselors through Kids Helpline, a national Australian counseling service that offers free online, email and telephone counseling for young people up to the age of 25. We employ tools from the traditions of ethnomethodology and conversation analysis to analyze the ways in which counselors from Kids Helpline request that their clients call them, and hence change the modality of their counseling relationship, from email to telephone counseling. This paper shows the counselors’ three multi-layered approaches in these emails as they negotiate the potentially delicate task of requesting and persuading a client to change the trajectory of their counseling relationship from text to talk without placing that relationship in jeopardy.

Address terms in turn beginnings: Managing disalignment and disaffiliation in telephone counselling

This paper examines use of address terms by counsellors on a telephone counselling service for children and young people. Drawing on conversation analytic findings and methods, we show how personal names are used in the management of structural and interpersonal aspects of counselling interaction. Focusing on address terms in turn-beginnings - where a name is used as, or as part of, a preface - the analysis shows that address terms are used in turns that are not fitted with prior talk in terms of either the activity or affective stance of the client. We discuss two environments in which this practice is observed: in beginning turns that initiate a new action sequence, and in turns that challenge the client’s position. Our focus is on the use of client names in the context of producing disaligning or disaffiliative actions. In disaligned actions, counsellors produced sequentially disjunctive turns that regularly involved a return to a counselling agenda. In disaffiliative actions counsellors presented a stance that did not fit with the affective stance of the client in the prior turn, for instance, in disagreeing with or complimenting the client. The paper discusses how such turns invoke a counselling agenda and how name use is used in the management of rapport and trust in counselling interaction.

New Evidence for Structured Telephone Support in the Management of Patients with Heart Failure [Letter to Editor]

Letter to the Editor of New England Journal of Medicine on behalf of the Cochrane Systematic Review team.

A survey on six sigma implementation in Singapore service industries

The concept of Six Sigma was initiated in the 1980s by Motorola. Since then it has been implemented in several manufacturing and service organizations. In case of services, health care and finance were major beneficiaries till now. The application of Six Sigma is gradually picking up in other services like; call centers, utilities and public services. This paper provides empirical evidence on Six Sigma implementation in service industries in Singapore. By using a sample size of 50 service organizations (10 responses are from organizations which have implemented Six Sigma), the paper helps in understanding the status of Six Sigma in service organizations in Singapore. The findings confirm the inclusion of critical success factors, critical to quality characteristics, tools and key performance indicators as observed from the literature. The revelation of “not relevant” as a reason for not implementing Six Sigma shows the need for understanding specific requirements of service organizations before its application.

Telemonitoring or Structured Telephone Support Programmes for Patients with Chronic Heart Failure: Systematic Review and Meta-Analysis

Objective: To determine whether remote monitoring (structured telephone support or telemonitoring) without regular clinic or home visits improves outcomes for patients with chronic heart failure. Data sources: 15 electronic databases, hand searches of previous studies, and contact with authors and experts. Data extraction: Two investigators independently screened the results. Review methods: Published randomised controlled trials comparing remote monitoring programmes with usual care in patients with chronic heart failure managed within the community. Results: 14 randomised controlled trials (4264 patients) of remote monitoring met the inclusion criteria: four evaluated telemonitoring, nine evaluated structured telephone support, and one evaluated both. Remote monitoring programmes reduced the rates of admission to hospital for chronic heart failure by 21% (95% confidence interval 11% to 31%) and all cause mortality by 20% (8% to 31%); of the six trials evaluating health related quality of life three reported significant benefits with remote monitoring, and of the four studies examining healthcare costs with structured telephone support three reported reduced cost and one no effect. Conclusion: Programmes for chronic heart failure that include remote monitoring have a positive effect on clinical outcomes in community dwelling patients with chronic heart failure.

Building information modeling in the Australian architecture engineering and construction industry

Building Information Modeling (BIM) is a modern approach to the design, documentation, delivery, and life cycle management of buildings through the use of project information databases coupled with object-based parametric modeling. BIM has the potential to revolutionize the Architecture, Engineering and Construction (AEC) industry in terms of the positive impact it may have on information flows, working relationships between project participants from different disciplines and the resulting benefits it may achieve through improvements to conventional methods. This chapter reviews the development of BIM, the extent to which BIM has been implemented in Australia, and the factors which have affected the up-take of BIM. More specifically, the objectives of this chapter are to investigate the adoption of BIM in the Australian AEC industry and factors that contribute towards the uptake (or non uptake) of BIM. These objectives are met by a review of the related literature in the first instance, followed by the presentation of the results of a 2007 postal questionnaire survey and telephone interviews of a random sample of professionals in the Australian AEC industry. The responses suggest that less than 25 percent of the sample had been involved in BIM – rather less than might be expected from reading the literature. Also, of those who have been involved with BIM, there has been very little interdisciplinary collaboration. The main barriers impeding the implementation of BIM widely across the Australian AEC industry are also identified. These were found to be primarily a lack of BIM expertise, lack of awareness and resistance to change. The benefits experienced as a result of using BIM are also discussed. These include improved design consistency, better coordination, cost savings, higher quality work, greater productivity and increased speed of delivery. In terms of conclusion, some suggestions are made concerning the underlying practical reasons for the slow up-take of BIM and the successes for those early adopters. Prospects for future improvement are discussed and proposals are also made for a large scale worldwide comparative study covering industry-wide participants

Convenience, loyal, and customising users : a survey of the behaviours and intentions of young online news users in Australia

The implications of the shift to online news consumption for journalism cultures and practices have attracted considerable scholarly attention and public debate. Less well considered are the implications of online news consumption for and by young people. This paper reports on research into the behaviours and intentions of online news consumers, 18-30 years of age, to propose three distinctive types of user (convenience, loyal and customising). Also opened up for discussion are questions about the strategic value to commercial news organisations of audience-centred empirical research that seeks to respond the crisis of professional journalism.

A randomized trial of a telephone-delivered exercise intervention for non-urban dwelling women newly diagnosed with breast cancer : exercise for health

Physical activity is important following breast cancer. Trials of non-face-to-face interventions are needed to assist in reaching women living outside major metropolitan areas. This study seeks to evaluate the feasibility and effectiveness of a telephone-delivered, mixed aerobic and resistance exercise intervention for non-urban Australian women with breast cancer. A randomized controlled trial comparing an 8-month intervention delivered by exercise physiologists (n = 73) to usual care (n = 70). Sixty-one percent recruitment rate and 96% retention at 12 months; 79% of women in the intervention group received at least 75% of calls; odds (OR, 95% CI) of meeting intervention targets favored the intervention group for resistance training (OR 3.2; 1.2, 8.9) and aerobic (OR 2.1; 0.8, 5.5) activity. Given the limited availability of physical activity programs for non-urban women with breast cancer, results provide strong support for feasibility and modest support for the efficacy of telephone-delivered interventions.

Peer state assessment of TxDOT maintenance program and practices, part II : test section survey findings and recommendations

This paper presents a road survey as part of a workshop conducted by the Texas Department of Transportation (TxDOT) to evaluate and improve the maintenance practices of the Texas highway system. Directors of maintenance from six peer states (California, Kansas, Georgia, Missouri, North Carolina, and Washington) were invited to this 3-day workshop. One of the important parts of this workshop was a Maintenance Test Section Survey (MTSS) to evaluate a number of pre-selected one-mile roadway sections. The workshop schedule allowed half a day to conduct the field survey and 34 sections were evaluated. Each of the evaluators was given a booklet and asked to rate the selected road sections. The goals of the MTSS were to: 1. Assess the threshold level at which maintenance activities are required as perceived by the evaluators from the peer states; 2. Assess the threshold level at which maintenance activities are required as perceived by evaluators from other TxDOT districts; and 3. Perform a pilot evaluation of the MTSS concept. This paper summarizes the information obtained from survey and discusses the major findings based on a statistical analysis of the data and comments from the survey participants.

Home sustainability policy and mandatory disclosure. a survey of buyer and seller participation and awareness in Qld

Sustainability Declarations were introduced by the Queensland State Government on 1 January 2010 as a mandatory disclosure measure for all dwelling sales in the State. The purpose of this paper is to assess the impact this policy decision has had in the homebuyer decision-making process in the first year since its introduction and to consider the effectiveness of the legislation in meeting its policy objectives. This quantitative research comprised a two-part process: the first stage surveyed the level of compliance by the real estate industry with the legislative requirements. Stage two comprised an online survey of Real Estate Institute of Queensland members to determine what impact the Sustainability Declaration has had on home buyer decision making and how effective the legislative mechanisms have been in achieving the policy objectives. This paper assesses the initial impact of this initiative over its first year in operation. These preliminary findings indicate a high level of compliance from the real estate industry, however results confirm that sustainability is yet to become a criterion of relevance to the majority of homebuyers in Queensland. These quantitative findings support anecdotal evidence that the objectives of the legislation to increase homebuyer awareness and relevance of sustainability issues in the home are not being achieved. Sustainability Declarations are a first step in raising homebuyer awareness of the importance of sustainability in housing. Further monitoring of this impact will be carried out over time. This is the first research undertaken to assess the impact of this new mandatory disclosure legislation in Queensland, Australia. The findings will inform policy makers and assist them to assess the effectiveness of the current legislation in achieving its policy objectives.

Has increasing the age for child passengers to wear child restraints improved the extent to which they are used? Results from an Australian focus group and survey study.

Acknowledgement that many children in Australia travel in restraints that do not offer them the best protection has led to recent changes in legislation such that the type of restraint for children under 7 years is now specified. This paper reports the results of two studies (observational; focus group/ survey) carried out in the state of Queensland to evaluate the effectiveness of these changes to the legislation. Observations suggested that almost all of the children estimated as aged 0-12 years were restrained (95%). Analysis of the type of restraint used for target-aged children (0-6 year olds) suggests that the proportion using an age-appropriate restraint has increased by an estimated 7% since enactment of the legislation. However, around 1 in 4 children estimated as aged under 7 years were using restraints too large for good fit. Results from the survey and focus group suggested parents were supportive of the changes in legislation. Non-Indigenous parents agreed that the changes had been necessary, were effective at getting children into the right restraints, were easy to understand as well as making it clear what restraint to use with children. Moreover, they did not see the legislation as too complicated or too hard to comply with. Indigenous parents who participated in a focus group also regarded the legislation as improving children’s safety. However, they identified the cost of restraints as an important barrier to compliance. In summary, the legislation appears to have had a positive effect on compliance levels and on raising parental awareness of the need to restrain children child-specific restraints for longer. However, it would seem that an important minority of parents transition their children into larger restraints too early for optimal protection. Intervention efforts should aim to better inform these parents about appropriate ages for transition, especially from forward facing childseats. This could potentially be through use of other important transitions that occur at the same age, such as starting school. The small proportion of parents who do not restrain their children at all are also an important community sector to target. Finally, obtaining restraints presents a significant barrier to compliance for parents on limited incomes and interventions are needed to address this.

Opinions, attitudes and driving experiences of car and racing "enthusiasts" : results of the Ontario Car and Racing Club Survey

In recent years, car club and racing websites and forums have become an increasingly popular way for car enthusiasts to access racing and car club news, chat-rooms and message boards. However, no North American research has been found that has examined opinions and driving experiences of car and racing enthusiasts. The purpose of this study was to examine car club members’ opinions about and experiences with various aspects of driving, road safety and traffic legislation, with a particular focus on street racing. A web-based questionnaire (Survey Monkey) was developed using the expert panel method and was primarily based on validated instruments or questions that were developed from other surveys. The questionnaire included: 1) driver concerns regarding traffic safety issues and legislation; 2) attitudes regarding various driving activities; 3) leisure-time activities, including club activities; 4) driving experiences, including offences and collisions; and 5) socio-demographic questions. The survey was pre- tested and piloted. Electronic information letters were sent out to an identified list of car clubs and forums situated in southern Ontario. Car club participants were invited to fill out the questionnaire. This survey found that members of car clubs share similar concerns regarding various road safety issues with samples of Canadian drivers, although a smaller percentage of car club members are concerned about speeding-related driving. Car club members had varied opinions regarding Ontario’s Street Racers, Stunt and Aggressive Drivers Legislation. The respondents agreed the most with the new offences regarding not sitting in the driver’s seat, having a person in the trunk, or driving as close as possible to another vehicle, pedestrian or object on or near the highway without a reason. The majority disagreed with police powers of impoundment and on-the-spot licence suspensions. About three quarters of respondents reported no collisions or police stops for traffic offences in the past five years. Of those who had been stopped, the most common offence was reported as speeding. This study is the first in Canada to examine car club members’ opinions about and experiences with various aspects of driving, road safety and traffic legislation. Given the ubiquity of car clubs and fora in Canada, insights on members’ opinions and practices provide important information to road safety researchers.

A roadside survey of unlicensed driving in Queensland

Unlicensed driving remains a serious problem in many jurisdictions, and while it does not play a direct causative role in road crashes, it undermines driver licensing systems and is linked to other high risk driving behaviours. Roadside licence check surveys represent the most direct means of estimating the prevalence of unlicensed driving. The current study involved the Queensland Police Service (QPS) checking the licences of 3,112 drivers intercepted at random breath testing operations across Queensland between February and April 2010. Data was matched with official licensing records from Transport and Main Roads (TMR) via the drivers’ licence number. In total, 2,914 (93.6%) records were matched, with the majority of the 198 unmatched cases representing international or interstate licence holders (n = 156), leaving 42 unknown cases. Among the drivers intercepted at the roadside, 20 (0.6%) were identified as being unlicensed at the time, while a further 11 (0.4%) were driving unaccompanied on a Learner Licence. However, the examination of TMR licensing records revealed that an additional 9 individuals (0.3%) had a current licence sanction but were not identified as unlicensed by QPS. Thus, in total 29 of the drivers were unlicensed at the time, representing 0.9% of all the drivers intercepted and 1% of those for whom their licence records could be checked. This is considerably lower than the involvement of unlicensed drivers in fatal and serious injury crashes in Queensland, which is consistent with other research confirming the increased crash risk of the group. However, the number of unmatched records suggest that it is possible the on-road survey may have under-estimated the prevalence of unlicensed driving, so further development of the survey method is recommended.