Mixed methods research approach to the development and review of competency standards for dietitians

Aim: Competency standards support a range of professional activities including the accreditation of university courses. Reviewing these standards is essential to ensure universities continue to produce well equipped graduates, who can meet the challenge of changing workforce requirements. This paper has two aims: a) to provide an overview of the methodological approaches utilised for compilation and review of the Competency Standards for Dietetics and b) to evaluate the Dietitians Association of Australia’s Competency Standards and capture emerging and contemporary dietetic practice. Methods: A literature review of the methods used to develop Competency Standards for dietitians in Australia, including entry level, advanced level and DAA Fellow competencies and other specific areas of competency, such as public health nutrition and nutrition education is outlined and compared to other allied health professions. The mixed methods methodology used in the most recent review is described in more detail. Results: The history of Dietetic Competency Standards development and review in Australia is compared to dietetic Competency Standards internationally and within other health professions in Australia. The political context in which these standards have been developed in Australia and which has determined their format is also discussed. The results of the most recent Competency Standards review are reported to highlight emerging practice in Australia. Conclusion: The mixed methods approach used in this review provides rich data about contemporary dietetic practice. Our view supports a planned review of all Competency Standards to ensure practice informs education and credentialling and we recommend the Dietitians Association of Australia consider this in future

Comparison of two methods to assess malnutrition in community-dwelling people with Parkinson's disease

Nutritional status in people with Parkinson’s disease (PD) has previously been assessed in a number of ways including BMI, % weight loss and the Mini-Nutritional Assessment(MNA). The symptoms of the disease and the side effects of medication used to manage them result in a number of nutrition impact symptoms that can negatively influence intake. These include chewing and swallowing difficulties, lack of appetite, nausea, and taste and smell changes, among others. Community-dwelling people with PD, aged >18 years, were recruited (n=97, 61 M, 36 F). The Patient-Generated Subjective Global Assessment(PG-SGA) and (MNA) were used to assess nutritional status. Weight, height, mid-arm circumference(MAC) and calf circumference were measured. Based on SGA, 16(16.5%) were moderately malnourished (SGA B) while none were severely malnourished (SGA C). The MNA identified 2(2.0%) as malnourished and 22(22.7%) as at risk of malnutrition. Mean MNA scores were different between the three groups,F(2,37)=7.30,p<.05 but not different between SGA B (21.0(2.9)) and MNA at risk (21.8(1.4)) participants. MAC and calf circumference were also different between the three groups,F(2,37)=5.51,p<.05 and F(2,37)=15.33,p<.05 but not between the SGA B (26.2(4.2), 33.3(2.8)) and MNA at risk (28.4(5.6), 36.4(4.7)) participants. The MNA results are similar to other PD studies using MNA where prevalence of malnutrition was between 0-2% with 20-33% at risk of malnutrition. In this population, the PG-SGA may be more sensitive to assessing malnutrition where nutrition impact symptoms influence intake. With society’s increasing body size, it might also be more appropriate as it does not rely on MAC and calf circumference measures.

Within-subject intra- and inter-method consistency of two experimental risk attitude elicitation methods

We compare the consistency of choices in two methods to used elicit risk preferences on an aggregate as well as on an individual level. We asked subjects to choose twice from a list of nine decision between two lotteries, as introduced by Holt and Laury (2002, 2005) alternating with nine decisions using the budget approach introduced by Andreoni and Harbaugh (2009). We find that while on an aggregate(subject pool) level the results are (roughly) consistent, on an individual(within-subject) level,behavior is far from consistent. Within each method as well as across methods we observe low correlations. This again questions the reliability of experimental risk elicitation measures and the ability to use results from such methods to control for the risk aversion of subjects when explaining e�ects in other experimental games.

On the diversity analysis of the sequential slotted amplify-decode-and-forward protocol

In this paper, we review the sequential slotted amplify-decode-and-forward (SADF) protocol with half-duplex single-antenna and evaluate its performance in terms of pairwise error probability (PEP). We obtain the PEP upper bound of the protocol and find out that the achievable diversity order of the protocol is two with arbitrary number of relay terminals. To achieve the maximum achievable diversity order, we propose a simple precoder that is easy to implement with any number of relay terminals and transmission slots. Simulation results show that the proposed precoder achieves the maximum achievable diversity order and has similar BER performance compared to some of the existing precoders.

Sequential slotted amplify-and-forward with partial relay isolation

In this paper, we propose a novel relay ordering and scheduling strategy for the sequential slotted amplify-and-forward (SAF) protocol and evaluate its performance in terms of diversity-multiplexing trade-off (DMT). The relays between the source and destination are grouped into two relay clusters based on their respective locations. The proposed strategy achieves partial relay isolation and decreases the decoding complexity at the destination. We show that the DMT upper bound of sequential-SAF with the proposed strategy outperforms other amplify and forward protocols and is more practical compared to the relay isolation assumption made in the original paper [1]. Simulation result shows that the sequential-SAF protocol with the proposed strategy has better outage performance compared to the existing AF and non-cooperative protocols in high SNR regime.

Sequential slotted amplify-decode-and-forward

In this paper, we propose a novel slotted hybrid cooperative protocol named the sequential slotted amplify-decodeand-forward (SADF) protocol and evaluate its performance in terms of diversity-multiplexing trade-off (DMT). The relays between the source and destination are divided into two different groups and each relay either amplifies or decodes the received signal. We first compute the optimal DMT of the proposed protocol with the assumption of perfect decoding at the DF relays. We then derive the DMT closed-form expression of the proposed sequential-SADF and obtain the proximity gain bound for achieving the optimal DMT. With the proximity gain bound, we then found the distance ratio to achieve the optimal DMT performance. Simulation result shows that the proposed protocol with high proximity gain outperforms other cooperative communication protocols in high SNR regime.

Foundations of International Climate Law : Objectives, principles and methods

This chapter explores the objectives, principle and methods of climate law. The United Nations Framework Convention on Climate Change (UNFCCC) lays the foundations of the international regime by setting out its ultimate objectives in Article 2, the key principles in Article 3, and the methods of the regime in Article 4. The ultimate objective of the regime – to avoid dangerous anthropogenic interference – is examined and assessments of the Intergovernmental Panel on Climate Change (IPCC) are considered when seeking to understand the definition of this concept. The international environmental principles of: state sovereignty and responsibility, preventative action, cooperation, sustainable development, precaution, polluter pays and common but differentiated responsibility are then examined and their incorporation within the international climate regime instruments evaluated. This is followed by an examination of the methods used by the mitigation and adaptation regimes in seeking to achieve the objective of the UNFCCC. Methods of the mitigation regime include: domestic implementation of policies, setting of standards and targets and allocation of rights, use of flexibility mechanisms, and reporting. While it is noted that methods of the adaptation regime are still evolving, the latter includes measures such as impact assessments, national adaptation plans and the provision of funding.

Review of statistical methods for disease mapping

Cancer poses an undeniable burden to the health and wellbeing of the Australian community. In a recent report commissioned by the Australian Institute for Health and Welfare(AIHW, 2010), one in every two Australians on average will be diagnosed with cancer by the age of 85, making cancer the second leading cause of death in 2007, preceded only by cardiovascular disease. Despite modest decreases in standardised combined cancer mortality over the past few decades, in part due to increased funding and access to screening programs, cancer remains a significant economic burden. In 2010, all cancers accounted for an estimated 19% of the country's total burden of disease, equating to approximately $3:8 billion in direct health system costs (Cancer Council Australia, 2011). Furthermore, there remains established socio-economic and other demographic inequalities in cancer incidence and survival, for example, by indigenous status and rurality. Therefore, in the interests of the nation's health and economic management, there is an immediate need to devise data-driven strategies to not only understand the socio-economic drivers of cancer but also facilitate the implementation of cost-effective resource allocation for cancer management...

Guerrilla research tactics: alternative research methods

This case-study explores alternative and experimental methods of research data acquisition, through an emerging research methodology, ‘Guerrilla Research Tactics’ [GRT]. The premise is that the researcher develops covert tactics for attracting and engaging with research participants. These methods range between simple analogue interventions to physical bespoke artefacts which contain an embedded digital link to a live, interactive data collecting resource, such as an online poll, survey or similar. These artefacts are purposefully placed in environments where the researcher anticipates an encounter and response from the potential research participant. The choice of design and placement of artefacts is specific and intentional. DESCRIPTION: Additional information may include: the outcomes; key factors or principles that contribute to its effectiveness; anticipated impact/evidence of impact. This case-study assesses the application of ‘Guerrilla Research Tactics’ [GRT] Methodology as an alternative, engaging and interactive method of data acquisition for higher degree research. Extending Gauntlett’s definition of ‘new creative methods… an alternative to language driven qualitative research methods' (2007), this case-study contributes to the existing body of literature addressing creative and interactive approaches to HDR data collection. The case-study was undertaken with Masters of Architecture and Urban Design research students at QUT, in 2012. Typically students within these creative disciplines view research as a taxing and boring process, distracting them from their studio design focus. An obstacle that many students face, is acquiring data from their intended participant groups. In response to these challenges the authors worked with students to develop creative, fun, and engaging research methods for both the students and their research participants. GRT are influenced by and developed from a combination of participatory action research (Kindon, 2008) and unobtrusive research methods (Kellehear, 1993), to enhance social research. GRT takes un-obtrusive research in a new direction, beyond the typical social research methods. The Masters research students developed alternative methods for acquiring data, which relied on a combination of analogue design interventions and online platforms commonly distributed through social networks. They identified critical issues that required action by the community, and the processes they developed focused on engaging with communities, to propose solutions. Key characteristics shared between both GRT and Guerrilla Activism, are notions of political issues, the unexpected, the unconventional, and being interactive, unique and thought provoking. The trend of Guerrilla Activism has been adapted to: marketing, communication, gardening, craftivism, theatre, poetry, and art. Focusing on the action element and examining elements of current trends within Guerrilla marketing, we believe that GRT can be applied to a range of research areas within various academic disciplines.