Overdue choices : how information and role in decision-making influence women's preferences for induction for prolonged pregnancy

Background: Enabling women to make informed decisions is a crucial component of consumer-focused maternity care. Current evidence suggests that health care practitioners’ communication of care options may not facilitate patient involvement in decision-making. The aim of this study was to investigate the effect of specific variations in health caregiver communication on women’s preferences for induction of labor for prolonged pregnancy. Methods: A convenience sample of 595 female participants read a hypothetical scenario in which an obstetrician discusses induction of labor with a pregnant woman. Information provided on induction and the degree of encouragement for the woman’s involvement in decision-making was manipulated to create four experimental conditions. Participants indicated preference with respect to induction, their perceptions of the quality of information received, and other potential moderating factors. Results: Participants who received information that was directive in favor of medical intervention were significantly more likely to prefer induction than those given nondirective information. No effect of level of involvement in decision-making was found. Participants’ general trust in doctors moderated the relationship between health caregiver communication and preferences for induction, such that the influence of information provided on preferences for induction differed across levels of involvement in decision-making for women with a low trust in doctors, but not for those with high trust. Many women were not aware of the level of information required to make an informed decision. Conclusions: Our findings highlight the potential value of strategies such as patient decision aids and health care professional education to improve the quality of information available to women and their capacity for informed decision-making during pregnancy and birth. (BIRTH 39:3 September 2012)

Transferring a successful strategy for supporting accelerated nursing students from a small to a large cohort

In 2009 and 2010, withdrawal rates from a Pharmacology unit of accelerated QUT nursing students in the first year of their degree, were higher than for continuing students. The cohort of 216 accelerated students in 2011 had university or non-university qualification or equivalent experience and included domestic and international students. A previously tested intervention was introduced in 2011 to improve retention rates and support all Pharmacology students in their first year of nursing. The intervention involved a community website, on-line tutors and an “O week” workshop comprising information about library resources, effective learning strategies and learning tips from a previous student as well as review anatomy, physiology and microbiology lectures. Withdrawal rates for accelerated students in the Pharmacology unit improved and all students found the workshop and review lectures to be informative and valuable. The intervention was therefore successfully transferred to a large, diverse cohort of accelerated nursing students.

Optimising preventive maintenance strategy for production Lines

Preventive Maintenance (PM) is often applied to improve the reliability of production lines. A Split System Approach (SSA) based methodology is presented to assist in making optimal PM decisions for serial production lines. The methodology treats a production line as a complex series system with multiple (imperfect) PM actions over multiple intervals. The conditional and overall reliability of the entire production line over these multiple PM intervals are hierarchically calculated using SSA, and provide a foundation for cost analysis. Both risk-related cost and maintenance-related cost are factored into the methodology as either deterministic or random variables. This SSA based methodology enables Asset Management (AM) decisions to be optimised considering a variety of factors including failure probability, failure cost, maintenance cost, PM performance, and the type of PM strategy. The application of this new methodology and an evaluation of the effects of these factors on PM decisions are demonstrated using an example. The results of this work show that the performance of a PM strategy can be measured by its Total Expected Cost Index (TECI). The optimal PM interval is dependent on TECI, PM performance and types of PM strategies. These factors are interrelated. Generally, it was found that a trade-off between reliability and the number of PM actions needs to be made so that one can minimise Total Expected Cost (TEC) for asset maintenance.

An optimal under-frequency load shedding strategy considering distributed generators and load static characteristics

The well-established under-frequency load shedding (UFLS) is deemed to be the last of effective remedial measures against a severe frequency decline of a power system. With the ever-increasing size of power systems and the extensive penetration of distributed generators (DGs) in power systems, the problem of developing an optimal UFLS strategy is facing some new challenges. Given this background, an optimal UFLS strategy for a distribution system with DGs and load static characteristics taken into consideration is developed. Based on the frequency and the rate of change of frequency, the presented strategy consists of several basic rounds and a special round. In the basic round, the frequency emergency can be alleviated by quickly shedding some loads. In the special round, the frequency security can be maintained, and the operating parameters of the distribution system can be optimized by adjusting the output powers of DGs and some loads. The modified IEEE 37-node test feeder is employed to demonstrate the essential features of the developed optimal UFLS strategy in the MATLAB/SIMULINK environment.

GameFlow heuristics for designing and evaluating real-time strategy games

The GameFlow model strives to be a general model of player enjoyment, applicable to all game genres and platforms. Derived from a general set of heuristics for creating enjoyable player experiences, the GameFlow model has been widely used in evaluating many types of games, as well as non-game applications. However, we recognize that more specific, low-level, and implementable criteria are potentially more useful for designing and evaluating video games. Consequently, the research reported in this paper aims to provide detailed heuristics for designing and evaluating one specific game genre, real-time strategy games. In order to develop these heuristics, we conducted a grounded theoretical analysis on a set of professional game reviews and structured the resulting heuristics using the GameFlow model. The resulting 165 heuristics for designing and evaluating real-time strategy games are presented and discussed in this paper.

Using ‘think aloud’ as a strategy for improving clinical reasoning in high fidelity case-based simulation for undergraduate nursing students.

Theme Paper for Curriculum innovation and enhancement theme AIM: This paper reports on a research project that trialled an educational strategy implemented in an undergraduate nursing curriculum. The project aimed to explore the effectiveness of ‘think aloud’ as a strategy for improving clinical reasoning for students in simulated clinical settings. BACKGROUND: Nurses are required to apply and utilise critical thinking skills to enable clinical reasoning and problem solving in the clinical setting (Lasater, 2007). Nursing students are expected to develop and display clinical reasoning skills in practice, but may struggle articulating reasons behind decisions about patient care. The ‘think aloud’ approach is an innovative learning/teaching method which can create an environment suitable for developing clinical reasoning skills in students (Banning, 2008, Lee and Ryan-Wenger, 1997). This project used the ‘think aloud’ strategy within a simulation context to provide a safe learning environment in which third year students were assisted to uncover cognitive approaches to assist in making effective patient care decisions, and improve their confidence, clinical reasoning and active critical reflection about their practice. MEHODS: In semester 2 2011 at QUT, third year nursing students undertook high fidelity simulation (some for the first time), commencing in September of 2011. There were two cohorts for strategy implementation (group 1= used think aloud as a strategy within the simulation, group 2= no specific strategy outside of nursing assessment frameworks used by all students) in relation to problem solving patient needs. The think aloud strategy was described to students in their pre-simulation briefing and allowed time for clarification of this strategy. All other aspects of the simulations remained the same, (resources, suggested nursing assessment frameworks, simulation session duration, size of simulation teams, preparatory materials). Ethics approval has been obtained for this project. RESULTS: Results of a qualitative analysis (in progress- will be completed by March 2012) of student and facilitator reports on students’ ability to meet the learning objectives of solving patient problems using clinical reasoning and experience with the ‘think aloud’ method will be presented. A comparison of clinical reasoning learning outcomes between the two groups will determine the effect on clinical reasoning for students responding to patient problems. CONCLUSIONS: In an environment of increasingly constrained clinical placement opportunities, exploration of alternate strategies to improve critical thinking skills and develop clinical reasoning and problem solving for nursing students is imperative in preparing nurses to respond to changing patient needs.

Optimized strategy for integrated traffic and transit signal control

This paper proposes a unique and innovative approach to integrate transit signal priority control into a traffic adaptive signal control strategy. The proposed strategy was named OSTRAC (Optimized Strategy for integrated TRAffic and TRAnsit signal Control). The cornerstones of OSTRAC include an online microscopic traffic f low prediction model and a Genetic Algorithm (GA) based traffic signal timing module. A sensitivity analysis was conducted to determine the critical GA parameters. The developed traffic f low model demonstrated reliable prediction results through a test. OSTRAC was evaluated by comparing its performance to three other signal control strategies. The evaluation results revealed that OSTRAC efficiently and effectively reduced delay time of general traffic and also transit vehicles.

Meta-regulation approach of law : a potential legal strategy to develop socially responsible business self-regulation in least developed common law countries

In the corporate regulation landscape, 'meta-regulation' is a comparatively new legal approach. The sketchy role of state promulgated authoritative laws in pluralized society and scepticism in corporate self-regulation's role have resulted in the development of this legal approach. It has opened up possibilities to synthesize corporate governance to add social values in corporate self-regulation. The core of this approach is the fusion of responsive and reflexive legal strategies to combine regulators and regulatees for reaching a particular goal. This paper argues that it is a potential strategy that can be successfully deployed to develop a socially responsible corporate culture for the business enterprises, so that they will be able to acquire social, environmental and ethical values in their self-regulation sustainably. Taking Bangladeshi corporate laws as an instance, this paper also evaluates the scope of incorporating this approach in laws of the least developed common law countries in general.

Dynamic capabilities and performance : strategy, structure and environment

Dynamic capabilities are widely considered to incorporate those processes that enable organizations to sustain superior performance over time. In this paper, we argue theoretically and demonstrate empirically that these effects are contingent on organizational structure and the competitive intensity in the market. Results from partial least square structural equation modeling (PLS-SEM) analyses indicate that organic organizational structures facilitate the impact of dynamic capabilities on organizational performance. Furthermore, we find that the performance effects of dynamic capabilities are contingent on the competitive intensity faced by firms. Our findings demonstrate the performance effects of internal alignment between organizational structure and dynamic capabilities, as well as the external fit of dynamic capabilities with competitive intensity. We outline the advantages of PLS-SEM for modeling latent constructs, such as dynamic capabilities, and conclude with managerial implications.

Condition-based maintenance optimisation without a predetermined strategy structure for a two-component series system

Most existing research on maintenance optimisation for multi-component systems only considers the lifetime distribution of the components. When the condition-based maintenance (CBM) strategy is adopted for multi-component systems, the strategy structure becomes complex due to the large number of component states and their combinations. Consequently, some predetermined maintenance strategy structures are often assumed before the maintenance optimisation of a multi-component system in a CBM context. Developing these predetermined strategy structure needs expert experience and the optimality of these strategies is often not proofed. This paper proposed a maintenance optimisation method that does not require any predetermined strategy structure for a two-component series system. The proposed method is developed based on the semi-Markov decision process (SMDP). A simulation study shows that the proposed method can identify the optimal maintenance strategy adaptively for different maintenance costs and parameters of degradation processes. The optimal maintenance strategy structure is also investigated in the simulation study, which provides reference for further research in maintenance optimisation of multi-component systems.

Securities market regulators’ use of the ‘please explain’ queries sanction and its power of compliance

The aim of this study is to investigate the compliance impact of price queries issued by a securities market operator to its participating firms. Market operators in Australia and New Zealand, such as the Australian Securities Exchange and the New Zealand Securities Exchange, have the regulatory power in their rules to issue queries to its market participants to explain unusual fluctuations in trading price or volume in the market. The operator will issue a price query where it believes that the market has not been fully informed as to price relevant information. Responsive regulation has informed much of the regulatory debate in securities laws in our region. We posit that price queries are one strategy that a market operator can use in communicating its enforcement expectations to its stakeholder. However, whilst responsive regulation informs regulatory choices, an alternate view seeks to explain why participants respond to these regulatory strategies, and we use disclosure behaviour after price queries to test compliance behaviour

Integrating collaborative filtering and matching-based search for product recommendation

Currently, recommender systems (RS) have been widely applied in many commercial e-commerce sites to help users deal with the information overload problem. Recommender systems provide personalized recommendations to users and thus help them in making good decisions about which product to buy from the vast number of product choices available to them. Many of the current recommender systems are developed for simple and frequently purchased products like books and videos, by using collaborative-filtering and content-based recommender system approaches. These approaches are not suitable for recommending luxurious and infrequently purchased products as they rely on a large amount of ratings data that is not usually available for such products. This research aims to explore novel approaches for recommending infrequently purchased products by exploiting user generated content such as user reviews and product click streams data. From reviews on products given by the previous users, association rules between product attributes are extracted using an association rule mining technique. Furthermore, from product click streams data, user profiles are generated using the proposed user profiling approach. Two recommendation approaches are proposed based on the knowledge extracted from these resources. The first approach is developed by formulating a new query from the initial query given by the target user, by expanding the query with the suitable association rules. In the second approach, a collaborative-filtering recommender system and search-based approaches are integrated within a hybrid system. In this hybrid system, user profiles are used to find the target user’s neighbour and the subsequent products viewed by them are then used to search for other relevant products. Experiments have been conducted on a real world dataset collected from one of the online car sale companies in Australia to evaluate the effectiveness of the proposed recommendation approaches. The experiment results show that user profiles generated from user click stream data and association rules generated from user reviews can improve recommendation accuracy. In addition, the experiment results also prove that the proposed query expansion and the hybrid collaborative filtering and search-based approaches perform better than the baseline approaches. Integrating the collaborative-filtering and search-based approaches has been challenging as this strategy has not been widely explored so far especially for recommending infrequently purchased products. Therefore, this research will provide a theoretical contribution to the recommender system field as a new technique of combining collaborative-filtering and search-based approaches will be developed. This research also contributes to a development of a new query expansion technique for infrequently purchased products recommendation. This research will also provide a practical contribution to the development of a prototype system for recommending cars.

An evidence-informed strategy to prevent osteoporosis in Australia

Osteoporosis imposes a tremendous burden on Australia : 1.2 million Australians have osteoporosis and 6.3 million have Osteopenia. In the 2007-08 financial year, 82000 Australians suffered fragility fractures, of Which >17000 were hip fractures. In the 2000-01 financial year, direct costs were estimated at $1.9 billion per year and an additional $5.6 billion on indirect costs. Osteoporosis was designated a National Health Priority Area in 2002; however, implementation of national plans has not yet matched the rhetoric in terms of urgency. Building healthy bones throughout life, the Osteoporosis Australia strategy to prevent osteoporosis throughout the life cycle, presents an evidence-informed set of recommendations for consumers, health care professionals and policymakers. The strategy was adopted by consensus at the Osteoporosis Australia Summit in Sydney, 20 October 2011. Primary objectives throughout the life cycle are: to maximise peak bone mass during childhood and adolescence to prevent premature bone loss and improve or maintain muscle mass, strength and functional capacity in healthy adults to prevent and treat osteoporosis in order to minimise the risk of suffering fragility fractures, and reduce falls risk, in older people. The recommendations focus on three affordable and important interventions to ensure people have adequate calcium intake, vitamin D levels and appropriate, physical activity throughout their lives. Recommendations relevant to all stages of life include: daily dietary calcium intakes should be consistent with Australian and New Zealand guidelines serum levels of vitamin D in the general population should be above 50 nmol/L in winter or early spring for optimal bone health regular weight-bearing physical activity, Muscle strengthening exercises and challenging balance/ mobility activities should be conducted in a safe environment.