A randomized controlled trial of self-management programme improves health-related outcomes of older people with heart failure

Aims This paper is a report on the effectiveness of a self-management programme based on the self-efficacy construct, in older people with heart failure. Background Heart failure is a major health problem worldwide, with high mortality and morbidity, making it a leading cause of hospitalization. Heart failure is associated with a complex set of symptoms that arise from problems in fluid and sodium retention. Hence, managing salt and fluid intake is important and can be enhanced by improving patients' self-efficacy in changing their behaviour. Design Randomized controlled trial. Methods Heart failure patients attending cardiac clinics in northern Taiwan from October 2006–May 2007 were randomly assigned to two groups: control (n = 46) and intervention (n = 47). The intervention group received a 12-week self-management programme that emphasized self-monitoring of salt/fluid intake and heart failure-related symptoms. Data were collected at baseline as well as 4 and 12 weeks later. Data analysis to test the hypotheses used repeated-measures anova models. Results Participants who received the intervention programme had significantly better self-efficacy for salt and fluid control, self-management behaviour and their heart failure-related symptoms were significantly lower than participants in the control group. However, the two groups did not differ significantly in health service use. Conclusion The self-management programme improved self-efficacy for salt and fluid control, self-management behaviours, and decreased heart failure-related symptoms in older Taiwanese outpatients with heart failure. Nursing interventions to improve health-related outcomes for patients with heart failure should emphasize self-efficacy in the self-management of their disease.

A parcel-scale assessment tool to measure sustainability through urban ecosystem components : the MUSIX model

In recent years a number of urban sustainability assessment frameworks are developed to better inform policy formulation and decision-making processes. This paper introduces one of these attempts in developing a comprehensive assessment tool—i.e., Micro-level Urban-ecosystem Sustainability IndeX (MUSIX). Being an indicator-based indexing model, MUSIX investigates the environmental impacts of land-uses on urban sustainability by measuring urban ecosystem components in local scale. The paper presents the methodology of MUSIX and demonstrates the performance of the model in a pilot test-bed—i.e., in Gold Coast, Australia. The model provides useful insights on the sustainability performance of the test-bed area. The parcel-scale findings of the indicators are used to identify local problems considering six main issues of urban development—i.e., hydrology; ecology; pollution; location; design, and; efficiency. The composite index score is used to propose betterment strategies to guide the development of local area plans in conjunction with the City's Planning Scheme. In overall, this study has shown that parcel-scale environmental data provides an overview of the local sustainability in urban areas as in the example of Gold Coast, which can also be used for setting environmental policy, objectives and targets.

From expert to tasks, expert nursing practice redefined?

Aim The aim of this paper was to explore the concept of expertise in nursing from the perspective of how it relates to current driving forces in health care in which it discusses the potential barriers to acceptance of nursing expertise in a climate in which quantification of value and cost containment run high on agendas. Background Expert nursing practice can be argued to be central to high quality, holistic, individualized patient care. However, changes in government policy which have led to the inception of comprehensive guidelines or protocols of care are in danger of relegating the ‘expert nurse’ to being an icon of the past. Indeed, it could be argued that expert nurses are an expensive commodity within the nursing workforce. Consequently, with this change to the use of clinical guidelines, it calls into question how expert nursing practice will develop within this framework of care. Method The article critically reviews the evidence related to the role of the Expert Nurse in an attempt to identify the key concepts and ideas, and how the inception of care protocols has implications for their role. Conclusion Nursing expertise which focuses on the provision of individualized, holistic care and is based largely on intuitive decision making cannot, should not be reduced to being articulated in positivist terms. However, the dominant power and decision-making focus in health care means that nurses must be confident in articulating the value of a concept which may be outside the scope of knowledge of those with whom they are debating. Relevance to clinical practice The principles of abduction or fuzzy logic may be useful in assisting nurses to explain in terms which others can comprehend, the value of nursing expertise.

Dynamics of mode transitions in inductively-coupled plasmas

The dynamics of transitions between the electrostatic and electromagnetic discharge modes of the low-frequency (460 kHz) inductively coupled plasma (LF ICP) reactor is studied. A series of images of plasma glows in Ar and N2 gases taken in the process of continuous variation of the input power confirms the discharge bistability and hysteresis. The operation regimes and parameters making the LF ICP reactor attractive for materials synthesis and processing applications are discussed.

Predicting movie ratings from audience behaviors

We propose a method of representing audience behavior through facial and body motions from a single video stream, and use these features to predict the rating for feature-length movies. This is a very challenging problem as: i) the movie viewing environment is dark and contains views of people at different scales and viewpoints; ii) the duration of feature-length movies is long (80-120 mins) so tracking people uninterrupted for this length of time is still an unsolved problem, and; iii) expressions and motions of audience members are subtle, short and sparse making labeling of activities unreliable. To circumvent these issues, we use an infrared illuminated test-bed to obtain a visually uniform input. We then utilize motion-history features which capture the subtle movements of a person within a pre-defined volume, and then form a group representation of the audience by a histogram of pair-wise correlations over a small-window of time. Using this group representation, we learn our movie rating classifier from crowd-sourced ratings collected by rottentomatoes.com and show our prediction capability on audiences from 30 movies across 250 subjects (> 50 hrs).

Can social resilience inform SA/SIA for adaptive planning for climate change in vulnerable regions?

Social resilience concepts are gaining momentum in environmental planning through an emerging understanding of the socio-ecological nature of biophysical systems. There is a disconnect, however, between these concepts and the sociological and psychological literature related to social resilience. Further still, both schools of thought are not well connected to the concepts of social assessment (SA) and social impact assessment (SIA) that are the more standard tools supporting planning and decision-making. This raises questions as to how emerging social resilience concepts can translate into improved SA/SIA practices to inform regional-scale adaptation. Through a review of the literature, this paper suggests that more cross-disciplinary integration is needed if social resilience concepts are to have a genuine impact in helping vulnerable regions tackle climate change.

100 futures now : designing sustainable futures

This presentation tells the story of an initiative in middle schooling at Kelvin Grove State College that begins in the Art studios, but reaches out to other disciplines and approaches, and to community and industry partners. It is inspired by the potential of 'future thinking' to become a compelling focus in contemporary art and design. Ethically it espouses a simple premise": every student in our classrooms now has a stake in creating livable, democratic and creative futures. Every student has the potential to be an active force in making that future. "100 Futures Now" is a project that envisages creative and imaginative students working in collaboration with artists and designers to visualize amazing futures and communicate their vision through art and design. "100 Futures Now" is one in a series of innovative curriculum initiatives at Kelvin Grove State College designed to build sustainable practice in arts education with the support of partners in industry and universities and with resident artists and designers. The model blends elements of art and design methodology to focus on the critical and creative thinking skills prioritised in ACARA and 21st century curriculum. The organisers are developing a sustainable model for working with resident artists that goes beyond a single arts intervention or extension/enrichment experience. In this model artists and designers are collaborators in the design of learning experiences that support future programs. This model also looks to transfer the benefits of residencies to the wider school community (in this case to middle schooling curriculum) and to teachers in other curriculum areas, and not exclusively to the immediate target group. In "100 Futures Now", story-making is the engine that powers the creative process. For this reason the program uses a series of imaginative scenarios, including those of speculative fiction and science, as departure points for inquiry, and applies the methodologies of arts and design practice to explore and express student story telling and story making. The story-making responses of student teams will naturally be expressed multimodally through visual art, design artifacts, installation, performance and digital works. The project’s focus on narratives and its modes of communication (performance/installation) are inspired by the work of experimental contemporary design practices and the speculative scenarios of U.K. based designers Anthony Dunne and Fiona Raby. Thanks to the support of an Arts Queensland Artist-in -Residence grant in 2014, resident artists and designers who work with a diversity of ideas and approaches ranging over science, bio-ethics, biodiversity, behavior and ethics, ambient sound, urbanism, food, and wearable design, will work with middle school students as catalysts for deeper thinking and creative action. All these rich fields for future speculation will become triggers for team inquiry into the deeper connections between the past, the present, and future challenges such as climate, waste, energy, sustainability and resilience. These imagined futures will form the platform for a critical, sustainability/design futures approach that will involve questioning assumptions and empowering students as agents rather than consumers of change.

Degree of value alignment : a grounded theory of rural nurse resignations

INTRODUCTION: The shortage of nurses willing to work in rural Australian healthcare settings continues to worsen. Australian rural areas have a lower retention rate of nurses than metropolitan counterparts, with more remote communities experiencing an even higher turnover of nursing staff. When retention rates are lower, patient outcomes are known to be poorer. This article reports a study that sought to explore the reasons why registered nurses resign from rural hospitals in the state of New South Wales, Australia. METHODS: Using grounded theory methods, this study explored the reasons why registered nurses resigned from New South Wales rural hospitals. Data were collected from 12 participants using semi-structured interviews; each participant was a registered nurse who had resigned from a rural hospital. Nurses who had resigned due to retirement, relocation or maternity leave were excluded. Interviews were transcribed verbatim and imported into NVivo software. The constant comparative method of data collection and analysis was followed until a core category emerged. RESULTS: Nurses resigned from rural hospitals when their personal value of how nursing should occur conflicted with the hospital's organisational values driving the practice of nursing. These conflicting values led to a change in the degree of value alignment between the nurse and hospital. The degree of value alignment occurred in three dynamic stages that nurses moved through prior to resigning. The first stage, sharing values, was a time when a nurse and a hospital shared similar values. The second stage was conceding values where, due to perceived changes in a hospital's values, a nurse felt that patient care became compromised and this led to a divergence of values. The final stage was resigning, a stage where a nurse 'gave up' as they felt that their professional integrity was severely compromised. The findings revealed that when a nurse and organisational values were not aligned, conflict was created for a nurse about how they could perform nursing that aligned with their internalised professional values and integrity. Resignation occurred when nurses were unable to realign their personal values to changed organisational values - the organisational values changed due to rural area health service restructures, centralisation of budgets and resources, cumbersome hierarchies and management structures that inhibited communication and decision making, out-dated and ineffective operating systems, insufficient and inexperienced staff, bullying, and a lack of connectedness and shared vision. CONCLUSIONS: To fully comprehend rural nurse resignations, this study identified three stages that nurses move through prior to resignation. Effective retention strategies for the nursing workforce should address contributors to a decrease in value alignment and work towards encouraging the coalescence of nurses' and hospitals' values. It is imperative that strategies enable nurses to provide high quality patient care and promote a sense of connectedness and a shared vision between nurse and hospital. Senior managers need to have clear ways to articulate and imbue organisational values and be explicit in how these values accommodate nurses' values. Ward-level nurse managers have a significant responsibility to ensure that a hospital's values (both explicit and implicit) are incorporated into ward culture.

Standard business reporting in Australia : efficiency, effectiveness, or both?

The benefits of using eXtensible Business Reporting Language (XBRL) as a business reporting standard have been widely canvassed in the extant literature, in particular, as the enabling technology for standard business reporting tools. One of the key benefits noted is the ability of standard business reporting to create significant efficiencies in the regulatory reporting process. Efficiency-driven cost reductions are highly desirable by data and report producers. However, they may not have the same potential to create long-term firm value as improved effectiveness of decision making. This study assesses the perceptions of Australian business stakeholders in relation to the benefits of the Australian standard business reporting instantiation (SBR) for financial reporting. These perceptions were drawn from interviews of persons knowledgeable in XBRL-based standard business reporting and submissions to Treasury relative to SBR reporting options. The combination of interviews and submissions permit insights into the views of various groups of stakeholders in relation to the potential benefits. In line with predictions based on a transaction-cost economics perspective, interviewees who primarily came from a data and report-producer background mentioned benefits that centre largely on asset specificity and efficiency. The interviewees who principally came from a data and report-consumer background mentioned benefits that centre on reducing decision-making uncertainty and decision-making effectiveness. The data and report consumers also took a broader view of the benefits of SBR to the financial reporting supply chain. Our research suggests that advocates of SBR have successfully promoted its efficiency benefits to potential users. However, the effectiveness benefits of SBR, for example, the decision-making benefits offered to investors via standardised reports, while becoming more broadly acknowledged, remain not a priority for all stakeholders.

Statistics critical in securing our food supply

“World food security … is at its lowest in half a century,” wrote Julian Cribb FTSE, a wellknown consultant in science communication and founding editor of www.sciencealert. com.au in the lead article in the 2008 ATSE Focus magazine issue entitled “Food for the world: the nation’s challenge”. Food security continues to be a key national and international concern and it is pleasing to see this issue of Focus again exploring aspects of the topic with the aim of continuing to raise awareness of issues and influencing relevant policy decisions. Statistics (or statistical science, more broadly) has been critical to the information and decision-making value chain needed to optimise agriculture and the food supply chain. The key steps are most often addressed by multidisciplinary research groups including statisticians in collaboration with life and physical scientists, agri-industry personnel and other relevant stakeholders.

Teaching dispute resolution ethics in the law curriculum

Dispute resolution processes such as mediation are now central to contemporary legal practice. For this reason it is critical that the law curriculum includes instruction on mediation ethics, so that law graduates enter the profession equipped to deal with ethical dilemmas arising in this context. However, our recent content analysis of the unit outlines for professional responsibility subjects in Australian law schools indicates that this important area of legal ethics is often excluded from the curriculum. In most Australian law schools, dispute resolution subjects (where mediation ethics might also be considered) continue to be offered as stand-alone electives in the law degree. This means that many law students are graduating without the ethical knowledge and judgment-making skills needed in dispute resolution environments. This is contrary to the intentions of the Threshold Learning Outcomes for Law. This paper argues that the current paucity of mediation ethics instruction in the Australian law curriculum is problematic, given mediation’s relevance to contemporary legal practice. The paper discusses the importance of including mediation ethics in the law curriculum, and the importance of dispute resolution more broadly as a mandatory component of the law degree in Australia. It offers an outline of a possible mediation ethics module that could be included in professional responsibility subjects.

Beyond equivalency: Repositioning artistic research within the Australian university sector

Presented in concept at the ACUADS 2008 conference, this paper reports on a research study conducted for PhD into how artistic researchers have been accommodated in the Australian university research management system, and the impacts experienced by artistic researchers through this location. It draws upon a wide range of data to provide the first analysis of this topic reported across all artistic disciplines in Australia in relation to university experiences and updates the Strand Report in 1998 in relation to government policy. Data sources include a correlation of literature from arts disciplines with that of higher education management and government policies; survey responses from of heads of academic units containing artistic researchers in over 40% of Australian universities; interviews with 27 artistic researchers in three case study universities; and interviews with longstanding expert commentators on artistic research and Deputy Vice Chancellors responsible for research. The study suggests that while limited progress has been made towards the acceptance of artistic research as an equivalent and legitimate research endeavour, significant structural, cultural and practical challenges remain which are undermining relationships between universities and their artistic staff and engendering behavioural changes within artistic practitioners that can affect the nature and quality of artistic work that is produced. Reflecting the voices of artistic researchers across the broad visual and performing arts disciplinary spectrum from early to senior career academics, it explores ways forward for universities, and artistic researchers themselves, to secure greater equity and recognition for artistic research.

Calibration of treatment time intensity modulated EPID images for anatomical imaging

Intensity Modulated Radiotherapy (IMRT) is a well established technique for delivering highly conformal radiation dose distributions. The complexity of the delivery techniques and high dose gradients around the target volume make verification of the patient treatment crucial to the success of the treatment. Conventional treatment protocols involve imaging the patient prior to treatment, comparing the patient set-up to the planned set-up and then making any necessary shifts in the patient position to ensure target volume coverage. This paper presents a method for calibrating electronic portal imaging device (EPID) images acquired during IMRT delivery so that they can be used for verifying the patient set-up.

Review of "English language education across Greater China"; edited by Anwei Feng

I formally learned English from Year Four until the completion of my undergraduate study in China. Because of this personal history, I was keen to review this book and revisit English education in China. The list of contributors to the book includes Anwei Feng (editor) and his colleagues, who play an insider role in English language practice, research, and policy-making in “Greater China”. Greater China according to Feng, can be defined as geographically close, demographically Chinese-dominated, and culturally, economically, and socio-politically interrelated countries and territories where Chinese is either the mother tongue or used as an official language.

Consumer’s persistence in solving their own problem with self‐service technology

An increasing range of technology services are now offered on a self-service basis. However, problems with self-service technologies (SSTs) occur at times due to the technical error, staff error, or consumers’ own mistakes. Considering the role of consumers as co-producers in the SST context, we aim to study consumer’s behaviours, strategies, and decision making in solving their problem with SST and identify the factors contributing to their persistence in solving the problem. This study contributes to the information systems research, as it is the first study that aims to identify such a process and the factors affecting consumers’ persistence in solving their problem with SST. A focus group with user support staff has been conducted, yielding some initial results that helped to conduct the next phases of the study. Next, using Critical Incident Technique, data will be gathered through focus groups with users, diary method, and think-aloud method.