415 resultados para Clinical performance


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The annual income return for rural property is based on two major factors being commodity prices and production yields. Commodity prices paid to rural producers can vary depending on the agricultural policies of their respective countries. Free trade countries, such as Australia and New Zealand are subject to the volatility of the world commodity markets to a greater extent than those farmers in protected or subsidised markets. In countries where rural production is protected or subsidised the annual income received by rural producers has been relatively stable. However, the high cost of agricultural protection is now being questioned, particularly in relation to the increasing economic costs of government services such as health, education and housing. When combined with the agricultural production limitations of climate, topography, chemical residues and disease issues, the impact of commodity prices on rural property income is crucial in the ability of rural producers to enter into or expand their holdings in agricultural land. These problems are then reflected in the volatility of the rural land capital returns and the investment performance of this property class. This paper will address the total and capital return performance of a major agricultural area and compare these returns on the basis of both location of land and land use. The comparison will be used to determine if location or actual land use has a greater influence on rural property capital returns. This performance analysis is based on over 35,000 rural sales transactions. These transactions cover all market based rural property transactions in New South Wales, Australia for the period January 1990 to December 2008. Correlation analysis and investment performance analysis has also been carried out to determine the possible relationships between location and land use and subsequent changes in rural land capital values.

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Unified Enterprise application security is a new emerging approach for providing protection against application level attacks. Conventional application security approach that consists of embedding security into each critical application leads towards scattered security mechanism that is not only difficult to manage but also creates security loopholes. According to the CSIIFBI computer crime survey report, almost 80% of the security breaches come from authorized users. In this paper, we have worked on the concept of unified security model, which manages all security aspect from a single security window. The basic idea is to keep business functionality separate from security components of the application. Our main focus was on the designing of frame work for unified layer which supports single point of policy control, centralize logging mechanism, granular, context aware access control, and independent from any underlying authentication technology and authorization policy.

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Recent years have seen the introduction of formalised accreditation processes in both community and residential aged care, but these only partially address quality assessment within this sector. Residential aged care in Australia does not yet have a standardised system of resident assessment related to clinical, rather than administrative, outcomes. This paper describes the development of a quality assessment tool aimed at addressing this gap. Utilising previous research and the results of nominal groups with experts in the field, the 21-item Clinical Care Indicators (CCI) Tool for residential aged care was developed and trialled nationally. The CCI Tool was found to be simple to use and an effective means of collecting data on the state of resident health and care, with potential benefits for resident care planning and continuous quality improvement within facilities and organisations. The CCI Tool was further refined through a small intervention study to assess its utility as a quality improvement instrument and to investigate its relationship with resident quality of life. The current version covers 23 clinical indicators, takes about 30 minutes to complete and is viewed favourably by nursing staff who use it. Current work focuses on psychometric analysis and benchmarking, which should enable the CCI Tool to make a positive contribution to the measurement of quality in aged care in Australia.

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While IS function has gained widespread attention for over two decades, there is little consensus among information systems (IS) researchers and practitioners on how best to evaluate IS function's support performance. This paper reports on preliminary findings of a larger research effort proceeds from a central interest in the importance of evaluating IS function's support in organisations. This study is the first that attempts to re-conceptualise and conceive evaluate IS function's support as a multi- dimensional formative construct. We argue that a holistic measure for evaluating evaluate IS function's support should consist of dimensions that together assess the variety of the support functions and the quality of the support services provided to end-users. Thus, the proposed model consists of two halves, "Variety" and "Quality" within which resides seven dimensions. The Variety half includes five dimensions: Training; Documentation; Data- related Support, Software-related Support; and Hardware-related Support. The Quality half includes two dimensions: IS Support Staff and Support Services Performance. The proposed model is derived using a directed content analysis of 83 studies; from top IS outlets, employing the characteristics of the analytic theory and consistent with formative construct development procedures.

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AIM: To draw on empirical evidence to illustrate the core role of nurse practitioners in Australia and New Zealand. BACKGROUND: Enacted legislation provides for mutual recognition of qualifications, including nursing, between New Zealand and Australia. As the nurse practitioner role is relatively new in both countries, there is no consistency in role expectation and hence mutual recognition has not yet been applied to nurse practitioners. A study jointly commissioned by both countries' Regulatory Boards developed information on the core role of the nurse practitioner, to develop shared competency and educational standards. Reporting on this study's process and outcomes provides insights that are relevant both locally and internationally. METHOD: This interpretive study used multiple data sources, including published and grey literature, policy documents, nurse practitioner program curricula and interviews with 15 nurse practitioners from the two countries. Data were analysed according to the appropriate standard for each data type and included both deductive and inductive methods. The data were aggregated thematically according to patterns within and across the interview and material data. FINDINGS: The core role of the nurse practitioner was identified as having three components: dynamic practice, professional efficacy and clinical leadership. Nurse practitioner practice is dynamic and involves the application of high level clinical knowledge and skills in a wide range of contexts. The nurse practitioner demonstrates professional efficacy, enhanced by an extended range of autonomy that includes legislated privileges. The nurse practitioner is a clinical leader with a readiness and an obligation to advocate for their client base and their profession at the systems level of health care. CONCLUSION: A clearly articulated and research informed description of the core role of the nurse practitioner provides the basis for development of educational and practice competency standards. These research findings provide new perspectives to inform the international debate about this extended level of nursing practice. RELEVANCE TO CLINICAL PRACTICE: The findings from this research have the potential to achieve a standardised approach and internationally consistent nomenclature for the nurse practitioner role.

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Following Youngjohn, Lees-Haley, and Binder's (1999) comment on Johnson and Lesniak-Karpiak's (1997) study that warnings lead to more subtle malingering, researchers have sought to better understand warning effects. However, such studies have been largely atheoretical and may have confounded warning and coaching. This study examined the effect on malingering of a warning that was based on criminological-sociological concepts derived from the rational choice model of deterrence theory. A total of 78 participants were randomly assigned to a control group, an unwarned simulator group, or one of two warned simulator groups. The warning groups comprised low- and high-level conditions depending on warning intensity. Simulator participants received no coaching about how to fake tests. Outcome variables were scores derived from the Test of Memory Malingering and Wechsler Memory Scale-III. When the rate of malingering was compared across the four groups, a high-level warning effect was found such that warned participants were significantly less likely to exaggerate than unwarned simulators. In an exploratory follow-up analysis, the warned groups were divided into those who reported malingering and those who did not report malingering, and the performance of these groups was compared to that of unwarned simulators and controls. Using this approach, results showed that participants who were deterred from malingering by warning performed no worse than controls. However, on a small number of tests, self-reported malingerers in the low-level warning group appeared less impaired than unwarned simulators. This pattern was not observed in the high-level warning condition. Although cautious interpretation of findings is necessitated by the exploratory nature of some analyses, overall results suggest that using a carefully designed warning may be useful for reducing the rate of malingering. The combination of some noteworthy effect sizes, despite low power and the small size of some groups, suggests that further investigation of the effects of warnings needs to continue to determine their effect more fully.

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Visual servoing has been a viable method of robot manipulator control for more than a decade. Initial developments involved positionbased visual servoing (PBVS), in which the control signal exists in Cartesian space. The younger method, image-based visual servoing (IBVS), has seen considerable development in recent years. PBVS and IBVS offer tradeoffs in performance, and neither can solve all tasks that may confront a robot. In response to these issues, several methods have been devised that partition the control scheme, allowing some motions to be performed in the manner of a PBVS system, while the remaining motions are performed using an IBVS approach. To date, there has been little research that explores the relative strengths and weaknesses of these methods. In this paper we present such an evaluation. We have chosen three recent visual servo approaches for evaluation in addition to the traditional PBVS and IBVS approaches. We posit a set of performance metrics that measure quantitatively the performance of a visual servo controller for a specific task. We then evaluate each of the candidate visual servo methods for four canonical tasks with simulations and with experiments in a robotic work cell.

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Creating sustainable urban environments is one of the challenging issues that need a clear vision and implementation strategies involving changes in governmental values and decision making process for local governments. Particularly, internalisation of environmental externalities of daily urban activities (e.g. manufacturing, transportation and so on) has immense importance for which local policies are formulated to provide better living conditions for the people inhabiting urban areas. Even if environmental problems are defined succinctly by various stakeholders, complicated nature of sustainability issues demand a structured evaluation strategy and well-defined sustainability parameters for efficient and effective policy making. Following this reasoning, this study involves assessment of sustainability performance of urban settings mainly focusing on environmental problems caused by rapid urban expansion and transformation. By taking into account land-use and transportation interaction, it tries to reveal how future urban developments would alter daily urban travel behaviour of people and affect the urban and natural environments. The paper introduces a grid-based indexing method developed for this research and trailed as a GIS-based decision support tool to analyse and model selected spatial and aspatial indicators of sustainability in the Gold Coast. This process reveals parameters of site specific relationship among selected indicators that are used to evaluate index-based performance characteristics of the area. The evaluation is made through an embedded decision support module by assigning relative weights to indicators. Resolution of selected grid-based unit of analysis provides insights about service level of projected urban development proposals at a disaggregate level, such as accessibility to transportation and urban services, and pollution. The paper concludes by discussing the findings including the capacity of the decision support system to assist decision-makers in determining problematic areas and developing intervention policies for sustainable outcomes of future developments.

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Clinical experience plays an important role in the development of expertise, particularly when coupled with reflection on practice. There is debate, however, regarding the amount of clinical experience that is required to become an expert. Various lengths of practice have been suggested as suitable for determining expertise, ranging from five years to 15 years. This study aimed to investigate the association between length of experience and therapists’ level of expertise in the field of cerebral palsy with upper limb hypertonicity using an empirical procedure named Cochrane–Weiss–Shanteau (CWS). The methodology involved re-analysis of quantitative data collected in two previous studies. In Study 1, 18 experienced occupational therapists made hypothetical clinical decisions related to 110 case vignettes, while in Study 2, 29 therapists considered 60 case vignettes drawn randomly from those used in Study 1. A CWS index was calculated for each participant's case decisions. Then, in each study, Spearman's rho was calculated to identify the correlations between the duration of experience and level of expertise. There was no significant association between these two variables in both studies. These analyses corroborated previous findings of no association between length of experience and judgemental performance. Therefore, length of experience may not be an appropriate criterion for determining level of expertise in relation to cerebral palsy practice.

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Intelligent surveillance systems typically use a single visual spectrum modality for their input. These systems work well in controlled conditions, but often fail when lighting is poor, or environmental effects such as shadows, dust or smoke are present. Thermal spectrum imagery is not as susceptible to environmental effects, however thermal imaging sensors are more sensitive to noise and they are only gray scale, making distinguishing between objects difficult. Several approaches to combining the visual and thermal modalities have been proposed, however they are limited by assuming that both modalities are perfuming equally well. When one modality fails, existing approaches are unable to detect the drop in performance and disregard the under performing modality. In this paper, a novel middle fusion approach for combining visual and thermal spectrum images for object tracking is proposed. Motion and object detection is performed on each modality and the object detection results for each modality are fused base on the current performance of each modality. Modality performance is determined by comparing the number of objects tracked by the system with the number detected by each mode, with a small allowance made for objects entering and exiting the scene. The tracking performance of the proposed fusion scheme is compared with performance of the visual and thermal modes individually, and a baseline middle fusion scheme. Improvement in tracking performance using the proposed fusion approach is demonstrated. The proposed approach is also shown to be able to detect the failure of an individual modality and disregard its results, ensuring performance is not degraded in such situations.

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The application of high-speed machine vision for close-loop position control, or visual servoing, of a robot manipulator. It provides a comprehensive coverage of all aspects of the visual servoing problem: robotics, vision, control, technology and implementation issues. While much of the discussion is quite general the experimental work described is based on the use of a high-speed binary vision system with a monocular "eye-in-hand" camera.

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Spectrum sensing is considered to be one of the most important tasks in cognitive radio. Many sensing detectors have been proposed in the literature, with the common assumption that the primary user is either fully present or completely absent within the window of observation. In reality, there are scenarios where the primary user signal only occupies a fraction of the observed window. This paper aims to analyse the effect of the primary user duty cycle on spectrum sensing performance through the analysis of a few common detectors. Simulations show that the probability of detection degrades severely with reduced duty cycle regardless of the detection method. Furthermore we show that reducing the duty cycle has a greater degradation on performance than lowering the signal strength.

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The genre of narratives has become the genre of choice in many classrooms since the introduction of NAPLAN into Australian schools. Yet, Knapp and Watkins (2005) argue that narratives are the least understood of all the genres. Despite wide-spread acceptance that narratives serve the social purpose of entertaining, they can also be more edgy, offering a powerful social or information role. This paper considers the effects of exposing novices to less standard realms of social discourse and disciplinary knowledge vis-a-vis a more clinical treatment focused on ‘standard’ narratives. I argue that we should not shy away from the challenges of edgy narratives just because our students are novice readers. The same holds true for our work in communities on the edge, that is where poverty, multiculturalism or multilingualism and systemic failure are the norm. I am part of an Australian Research Council (ARC) Linkage Grant (LP 0990289) working in such a community. Like many such situations, teachers in these communities are caught in the fray of establishing a dialogue between the culture of federally mandated performance orientated reforms and the cultures and discourses of the lives and future needs of their students (see Exley & Singh, in press).

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Objective. To provide a preliminary test of a Theory of Planned Behavior (TPB) belief-based intervention to increase adolescents’ sun protective behaviors in a high risk area, Queensland, Australia. Methods. In the period of October-November, 2007 and May-June, 2008, 80 adolescents (14.53 ± 0.69 years) were recruited from two secondary schools (one government and one private) in Queensland after obtaining student, parental, and school informed consent. Adolescents were allocated to either a control or intervention condition based on the class they attended. The intervention comprised three, one hour in-school sessions facilitated by Cancer Council Queensland employees with sessions covering the belief basis of the TPB (i.e., behavioral, normative, and control [barrier and motivator] sun-safe beliefs). Participants completed questionnaires assessing sun-safety beliefs, intentions, and behavior pre- and post-intervention. Repeated Measures Multivariate Analysis of Variance was used to test the effect of the intervention across time on these constructs. Results. Students completing the intervention reported stronger sun-safe normative and motivator beliefs and intentions and the performance of more sun-safe behaviors across time than those in the control condition. Conclusion. Strengthening beliefs about the approval of others and motivators for sun protection may encourage sun-safe cognitions and actions among adolescents.

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What happens when the traditional framing mechanisms of our performance environments are removed and we are forced as directors to work with actors in digital environments that capture performance in 360 degrees? As directors contend with the challenges of interactive performance, the emergence of the online audience and the powerful influence of the games industry, how can we approach the challenges of directing work that is performance captured and presented in real time using motion capture and associated 3D imaging software? The 360 degree real time capture of performance, while allowing for an unlimited amount of framing potential, demands a unique and uncompromisingly disciplined style of direction and performance that has thus far remained unstudied and unquantified. By a close analysis of the groundbreaking work of artists like Robert Zemeckis and the Wetta Digital studio it is possible to begin to quantify what the technical requirements and challenges of 360 degree direction might be, but little has been discovered about the challenges of communicating the unlimited potential of framing and focus to the actors who work with these directors within these systems. It cannot be argued that the potential of theatrical space has evolved beyond the physical and moved into a more accessible virtual and digitised form, so how then can we direct for this unlimited potential and where do we place the focus of our directed (and captured) performance?