Methodology to predict the safety performance of rural multilane highways [Final Report for NCHRP Project 17-29]

The objective of this research is to develop a methodology that predicts the safety performance of various elements considered in the planning, design, and operation of nonlimited- access rural multilane highways.

The impact of socialisation on graduates’ public service motivation : a mixed method study

The need to attract and retain a high calibre cadre of public servants today has resulted in a renaissance of interest in public service motivation (PSM) within public management literature. This article outlines a study of PSM with graduate employees within an Australian public sector. The study extends our understanding of PSM by adopting a longitudinal, mixed method design, including surveys and individual interviews, to consider the effects of socialisation on levels of PSM. Results show an organisation's mission and values do not affect individual PSM while work type and communication style is vital and organisational socialisation can provide a negative influence.

Developing and evaluating interventions that are applicable and relevant to inpatients and those who care for them; a multiphase, pragmatic action research approach

Background Randomised controlled trials may be of limited use to evaluate the multidisciplinary and multimodal interventions required to effectively treat complex patients in routine clinical practice; pragmatic action research approaches may provide a suitable alternative. Methods A multiphase, pragmatic, action research based approach was developed to identify and overcome barriers to nutritional care in patients admitted to a metropolitan hospital hip-fracture unit. Results Four sequential action research cycles built upon baseline data including 614 acute hip-fracture inpatients and 30 purposefully sampled clinicians. Reports from Phase I identified barriers to nutrition screening and assessment. Phase II reported post-fracture protein-energy intakes and intake barriers. Phase III built on earlier results; an explanatory mixed-methods study expanded and explored additional barriers and facilitators to nutritional care. Subsequent changes to routine clinical practice were developed and implemented by the treating team between Phase III and IV. These were implemented as a new multidisciplinary, multimodal nutritional model of care. A quasi-experimental controlled, ‘before-and-after’ study was then used to compare the new model of care with an individualised nutritional care model. Engagement of the multidisciplinary team in a multiphase, pragmatic action research intervention doubled energy and protein intakes, tripled return home discharge rates, and effected a 75% reduction in nutritional deterioration during admission in a reflective cohort of hip-fracture inpatients. Conclusions This approach allowed research to be conducted as part of routine clinical practice, captured a more representative patient cohort than previously reported studies, and facilitated exploration of barriers and engagement of the multidisciplinary healthcare workers to identify and implement practical solutions. This study demonstrates substantially different findings to those previously reported, and is the first to demonstrate that multidisciplinary, multimodal nutrition care reduces intake barriers, delivers a higher proportional increase in protein and energy intake compared with baseline than other published intervention studies, and improves patient outcomes when compared with individualised nutrition care. The findings are considered highly relevant to clinical practice and have high translation validity. The authors strongly encourage the development of similar study designs to investigate complex health problems in elderly, multi-morbid patient populations as a way to evaluate and change clinical practice.

Modelling busway operation with mixed stopping and non-stopping buses

This thesis investigated the complexity of busway operation with stopping and non-stopping buses using field data and microscopic simulation modelling. The proposed approach made significant recommendations to transit authorities to achieve the most practicable system capacity for existing and new busways. The empirical equations developed in this research and newly introduced analysis methods will be ideal tools for transit planners to achieve optimal reliability of busways.

Is group more cost effective than individual cognitive behaviour therapy? The evidence is not solid yet

This paper critically evaluates the empirical evidence of 36 studies regarding the comparative cost-effectiveness of group and individual cognitive behaviour therapy (CBT) as a whole, and also for specific mental disorders (e.g. depression, anxiety, substance abuse) or populations (e.g. children). Methods of calculating costs, as well as methods of comparing treatment outcomes were appraised and criticized. Overall, the evidence that group CBT is more cost-effective than individual CBT is mixed, with group CBT appearing to be more cost effective in treating depression and children, but less cost effective in treating drugs and alcohol dependence, anxiety and social phobias. In addition, methodological weaknesses in the studies assessed are noted. There is a need to improve cost calculation methodology, as well as more solid and a greater number of empirical cost-effectiveness studies before a firm conclusion can be reached that group CBT is more cost effective then individual CBT.

Multiple perspectives on quality of life for residents with dementia in long term care facilities: Protocol for a comprehensive Australian study

Background Dementia is a chronic illness without cure or effective treatment, which results in declining mental and physical function and assistance from others to manage activities of daily living. Many people with dementia live in long term care facilities, yet research into their quality of life (QoL) was rare until the last decade. Previous studies failed to incorporate important variables related to the facility and care provision or to look closely at the daily lives of residents. This paper presents a protocol for a comprehensive, multi-perspective assessment of QoL of residents with dementia living in long term care in Australia. A secondary aim is investigating the effectiveness of self-report instruments for measuring QoL. Methods The study utilizes a descriptive, mixed methods design to examine how facility, care staff, and resident factors impact QoL. Over 500 residents with dementia from a stratified, random sample of 53 facilities are being recruited. A sub-sample of 12 residents is also taking part in qualitative interviews and observations. Conclusions This national study will provide a broad understanding of factors underlying QoL for residents with dementia in long term care. The present study uses a similar methodology to the US-based Collaborative Studies of Long Term Care (CS-LTC) Dementia Care Study, applying it to the Australian setting.

Differential segmentation responses to an alcohol social marketing program

Objective This study seeks establish whether meaningful subgroups exist within a 14-16 year old adolescent population and if these segments respond differently to the Game On: Know Alcohol (GOKA) intervention, a school-based alcohol social marketing program. Methodology This study is part of a larger cluster randomized controlled evaluation of the Game On: Know Alcohol (GOKA) program implemented in 14 schools in 2013/2014. TwoStep cluster analysis was conducted to segment 2114 high school adolescents (14-16 years old) on the basis of 22 demographic, behavioral and psychographic variables. Program effects on knowledge, attitudes, behavioral intentions, social norms, expectancies and refusal self-efficacy of identified segments was subsequently examined. Results Three segments were identified: (1) Abstainers (2) Bingers (3) Moderate Drinkers. Program effects varied significantly across segments. The strongest positive change effects post participation were observed for the Bingers, while mixed effects were evident for Moderate Drinkers and Abstainers. Conclusions These findings provide preliminary empirical evidence supporting application of social marketing segmentation in alcohol education programs. Development of targeted programs that meet the unique needs of each of the three identified segments is indicated to extend the social marketing footprint in alcohol education.

Identifying relationships between symptom clusters and quality of life in adults with chronic mixed venous and arterial leg ulcers

The objective of this study was to identify symptom clusters and their effect on quality of life (QOL) of adults with chronic leg ulcers of mixed venous and arterial aetiology. A secondary analysis of data from four existing prospective longitudinal studies conducted by a wound healing research group in Australia was undertaken. A total of 110 patients who met the inclusion criteria were selected for this study. Exploratory factor analysis (EFA) was used to identify symptom clusters and correlational analyses to examine relationships between the identified symptom clusters and QOL. The EFA identified two distinct symptom clusters: a 'systemic symptom cluster' consisting of pain, fatigue and depressive symptoms; and a 'localised-leg symptom cluster' including pain, fatigue, oedema, lower limb inflammation and exudate. Physical QOL correlated significantly with the systemic symptom cluster (r = -0·055, P < 0·0001) and the localised-leg symptom cluster (r = -0·054, P < 0·0001), whereas mental QOL was associated only with the systemic symptom cluster (r = -0·038, P = 0·01). The results suggest that appropriate intervention strategies targeting specific symptom clusters should be developed. Targeting patients with symptom clusters is particularly important because they are at high risk and the most vulnerable for reduced QOL.

IdeaWall: Mixed mode distributed collaboration in enterprise environments

In early stages of design and modeling, computers and computer applications are often considered an obstacle, rather than a facilitator of the process. Most notably, brainstorms, process modeling with business experts, or development planning, are often performed by a team in front of a whiteboard. While "whiteboarding" is recognized as an effective tool, low-tech solutions that allow remote participants to contribute are still not generally available. This is a striking observation, considering that vast majority of teams in large organizations are distributed teams. And this has also been one of the key triggers behind the project described in this article, where a team of corporate researchers decided to identify state of the art technologies that could facilitate the scenario mentioned above. This paper is an account of a research project in the area of enterprise collaboration, with a strong focus on the aspects of human computer interaction in mixed mode environments, especially in areas of collaboration where computers still play a secondary role. It is describing a currently running corporate research project. © 2012 Springer-Verlag.

A dynamic real time scheduling methodology for the emergency department

This project constructs a scheduling solution for the Emergency Department. The schedules are generated in real-time to adapt to new patient arrivals and changing conditions. An integrated scheduling formulation assigns patients to beds and treatment tasks to resources. The schedule efficiency is assessed using waiting time and total care time experienced by patients. The solution algorithm incorporates dispatch rules, meta-heuristics and a new extended disjunctive graph formulation which provide high quality solutions in a fast time-frame for real time decision support. This algorithm can be implemented in an electronic patient management system to improve patient flow in the Emergency Department.

A methodology for extracting legal norms from regulatory documents

We present a methodology to extract legal norms from regulatory documents for their formalisation and later compliance checking. The need for the methodology is motivated from the shortcomings of existing approaches where the rule type and process aspects relevant to the rules are largely overlook. The methodology incorporates the well–known IF. . . THEN structure extended with the process aspect and rule type, and guides how to properly extract the conditions and logical structure of the legal rules for reasoning and modelling of obligations for compliance checking.

Agent-based simulation as a component of mixed methods in entrepreneurship research

As a new research method supplementing the existing qualitative and quantitative approaches, agent-based modelling and simulation (ABMS) may fit well within the entrepreneurship field because the core concepts and basic premises of entrepreneurship coincide with the characteristics of ABMS (McKelvey, 2004; Yang & Chandra, 2013). Agent-based simulation is a simulation method based on agent-based models. The agentbased models are composed of heterogeneous agents and their behavioural rules. By repeatedly carrying out agent-based simulations on a computer, the simulations reproduce each agent’s behaviour, their interactive process, and the emerging macroscopic phenomenon according to the flow of time. Using agent-based simulations, researchers may investigate temporal or dynamic effects of each agent’s behaviours.

Using mobile technology to motivate adolescents with type 1 diabetes mellitus: A systematic review of recent literature

Introduction Behavioural interventions have been shown to improve outcomes in patients with type 1 diabetes mellitus (T1DM). There are a small number of studies that suggest text-messages (TM), native mobile applications (NMAs), and other mobile tools may be useful platforms for delivering behavioural interventions to adolescents. Aim The aim of this study was to explore, by way of a systematic review of available literature, (a) the outcomes of interventions using mobile technology for youth with T1DM and (b) what mobile technologies, functional design elements and aesthetic design elements have the best evidence to support their use. Methods A search of six online databases returned 196 unique results, of which 13 met the inclusion criteria. Results Four studies were randomised controlled trials (RCTs), and all others prospective cohort studies. TM (10) was the most common intervention technology, while NMAs were used in four studies. The most common outcome measured was HbA1c (9); however, only three studies showed a significant decrease. Similarly, the results reported for other outcome measures were mixed. The studies included in this review suggest that interventions which have data collection and clinician support functionality may be more effective in improving adherence and glycaemic control, but more evidence is needed. Further, the evidence base supporting the use of NMAs in T1DM management for adolescents is weak, with most studies adopting TM as the intervention tool. Overall, the studies lack adequate descriptions of their methodology, and better quality studies are required to inform future intervention design.

Radon-222 activity flux measurement using activated charcoal canisters: Revisiting the methodology

The measurement of radon ((222)Rn) activity flux using activated charcoal canisters was examined to investigate the distribution of the adsorbed (222)Rn in the charcoal bed and the relationship between (222)Rn activity flux and exposure time. The activity flux of (222)Rn from five sources of varying strengths was measured for exposure times of one, two, three, five, seven, 10, and 14 days. The distribution of the adsorbed (222)Rn in the charcoal bed was obtained by dividing the bed into six layers and counting each layer separately after the exposure. (222)Rn activity decreased in the layers that were away from the exposed surface. Nevertheless, the results demonstrated that only a small correction might be required in the actual application of charcoal canisters for activity flux measurement, where calibration standards were often prepared by the uniform mixing of radium ((226)Ra) in the matrix. This was because the diffusion of (222)Rn in the charcoal bed and the detection efficiency as a function of the charcoal depth tended to counterbalance each other. The influence of exposure time on the measured (222)Rn activity flux was observed in two situations of the canister exposure layout: (a) canister sealed to an open bed of the material and (b) canister sealed over a jar containing the material. The measured (222)Rn activity flux decreased as the exposure time increased. The change in the former situation was significant with an exponential decrease as the exposure time increased. In the latter case, lesser reduction was noticed in the observed activity flux with respect to exposure time. This reduction might have been related to certain factors, such as absorption site saturation or the back diffusion of (222)Rn gas occurring at the canister-soil interface.

Non-Newtonian mixed convection flow from a horizontal circular cylinder with uniform surface heat flux

Mixed convection laminar two-dimensional boundary-layer flow of non-Newtonian pseudo-plastic fluids is investigated from a horizontal circular cylinder with uniform surface heat flux using a modified power-law viscosity model, that contains no unrealistic limits of zero or infinite viscosity; consequently, no irremovable singularities are introduced into boundary-layer formulations for such fluids. The governing boundary layer equations are transformed into a non-dimensional form and the resulting nonlinear systems of partial differential equations are solved numerically applying marching order implicit finite difference method with double sweep technique. Numerical results are presented for the case of shear-thinning fluids in terms of the fluid temperature distributions, rate of heat transfer in terms of the local Nusselt number.