Using qualitative mixed methods to study small health care organizations while maximising trustworthiness and authenticity

Background The primary health care sector delivers the majority of health care in western countries through small, community-based organizations. However, research into these healthcare organizations is limited by the time constraints and pressure facing them, and the concern by staff that research is peripheral to their work. We developed Q-RARA—Qualitative Rapid Appraisal, Rigorous Analysis—to study small, primary health care organizations in a way that is efficient, acceptable to participants and methodologically rigorous. Methods Q-RARA comprises a site visit, semi-structured interviews, structured and unstructured observations, photographs, floor plans, and social scanning data. Data were collected over the course of one day per site and the qualitative analysis was integrated and iterative. Results We found Q-RARA to be acceptable to participants and effective in collecting data on organizational function in multiple sites without disrupting the practice, while maintaining a balance between speed and trustworthiness. Conclusions The Q-RARA approach is capable of providing a richly textured, rigorous understanding of the processes of the primary care practice while also allowing researchers to develop an organizational perspective. For these reasons the approach is recommended for use in small-scale organizations both within and outside the primary health care sector.

Corneal confocal microscopy shown an improvement in small-fibre neuropathy in subjects with type 1 diabetes on continuous subcutaneous insulin infusion compared to multiple daily injection

Improved glycemic control is the only treatment that has been shown to be effective for diabetic peripheral neuropathy in patients with type 1 diabetes (1). Continuous subcutaneous insulin infusion (CSII) is superior to multiple daily insulin injection (MDI) for reducing HbA1c and hypoglycemic events (2). Here, we have compared the benefits of CSII compared withMDI for neuropathy over 24months....

Rethinking the value of simulation methods in the information systems research field : a call for reconstructing contribution for a broader audience

The impact of simulation methods for social research in the Information Systems (IS) research field remains low. A concern is our field is inadequately leveraging the unique strengths of simulation methods. Although this low impact is frequently attributed to methodological complexity, we offer an alternative explanation – the poor construction of research value. We argue a more intuitive value construction, better connected to the knowledge base, will facilitate increased value and broader appreciation. Meta-analysis of studies published in IS journals over the last decade evidences the low impact. To facilitate value construction, we synthesize four common types of simulation research contribution: Analyzer, Tester, Descriptor, and Theorizer. To illustrate, we employ the proposed typology to describe how each type of value is structured in simulation research and connect each type to instances from IS literature, thereby making these value types and their construction visible and readily accessible to the general IS community.

Selection procedures for module discovery : exploring evolutionary algorithms for cognitive science

Evolutionary algorithms are playing an increasingly important role as search methods in cognitive science domains. In this study, methodological issues in the use of evolutionary algorithms were investigated via simulations in which procedures were systematically varied to modify the selection pressures on populations of evolving agents. Traditional roulette wheel, tournament, and variations of these selection algorithms were compared on the “needle-in-a-haystack” problem developed by Hinton and Nowlan in their 1987 study of the Baldwin effect. The task is an important one for cognitive science, as it demonstrates the power of learning as a local search technique in smoothing a fitness landscape that lacks gradient information. One aspect that has continued to foster interest in the problem is the observation of residual learning ability in simulated populations even after long periods of time. Effective evolutionary algorithms balance their search effort between broad exploration of the search space and in-depth exploitation of promising solutions already found. Issues discussed include the differential effects of rank and proportional selection, the tradeoff between migration of populations towards good solutions and maintenance of diversity, and the development of measures that illustrate how each selection algorithm affects the search process over generations. We show that both roulette wheel and tournament algorithms can be modified to appropriately balance search between exploration and exploitation, and effectively eliminate residual learning in this problem.

Combustion analysis of microalgae methyl ester in a common rail direct injection diesel engine

In this study, the biodiesel properties and effects of blends of oil methyl ester petroleum diesel on a CI direct injection diesel engine is investigated. Blends were obtained from the marine dinoflagellate Crypthecodinium cohnii and waste cooking oil. The experiment was conducted using a four-cylinder, turbo-charged common rail direct injection diesel engine at four loads (25%, 50%, 75% and 100%). Three blends (10%, 20% and 50%) of microalgae oil methyl ester and a 20% blend of waste cooking oil methyl ester were compared to petroleum diesel. To establish suitability of the fuels for a CI engine, the effects of the three microalgae fuel blends at different engine loads were assessed by measuring engine performance, i.e. mean effective pressure (IMEP), brake mean effective pressure (BMEP), in cylinder pressure, maximum pressure rise rate, brake-specific fuel consumption (BSFC), brake thermal efficiency (BTE), heat release rate and gaseous emissions (NO, NOx,and unburned hydrocarbons (UHC)). Results were then compared to engine performance characteristics for operation with a 20% waste cooking oil/petroleum diesel blend and petroleum diesel. In addition, physical and chemical properties of the fuels were measured. Use of microalgae methyl ester reduced the instantaneous cylinder pressure and engine output torque, when compared to that of petroleum diesel, by a maximum of 4.5% at 50% blend at full throttle. The lower calorific value of the microalgae oil methyl ester blends increased the BSFC, which ultimately reduced the BTE by up to 4% at higher loads. Minor reductions of IMEP and BMEP were recorded for both the microalgae and the waste cooking oil methyl ester blends at low loads, with a maximum of 7% reduction at 75% load compared to petroleum diesel. Furthermore, compared to petroleum diesel, gaseous emissions of NO and NOx, increased for operations with biodiesel blends. At full load, NO and NOx emissions increased by 22% when 50% microalgae blends were used. Petroleum diesel and a 20% blend of waste cooking oil methyl ester had emissions of UHC that were similar, but those of microalgae oil methyl ester/petroleum diesel blends were reduced by at least 50% for all blends and engine conditions. The tested microalgae methyl esters contain some long-chain, polyunsaturated fatty acid methyl esters (FAMEs) (C22:5 and C22:6) not commonly found in terrestrial-crop-derived biodiesels yet all fuel properties were satisfied or were very close to the ASTM 6751-12 and EN14214 standards. Therefore, Crypthecodinium cohnii- derived microalgae biodiesel/petroleum blends of up to 50% are projected to meet all fuel property standards and, engine performance and emission results from this study clearly show its suitability for regular use in diesel engines.

Is retinal shape different in Asians and Caucasians? Estimation from peripheral refraction and peripheral eye length methods

Purpose:Race appears to be associated with myopiogenesis, with East Asians showing high myopia prevalence. Considering structural variations in the eye, it is possible that retinal shapes are different between races. The purpose of this study was to quantify and compare retinal shapes between racial groups using peripheral refraction (PR) and peripheral eye lengths (PEL). Methods:A Shin-Nippon SRW5000 autorefractor and a Haag-Streit Lenstar LS900 biometer measured PR and PEL, respectively, along horizontal (H) and vertical (V) fields out to ±35° in 5° steps in 29 Caucasian (CA), 16 South Asian (SA) and 23 East Asian (EA) young adults (spherical equivalent range +0.75D to –5.00D in all groups). Retinal vertex curvature Rv and asphericity Q were determined from two methods: a) PR (Dunne): The Gullstrand-Emsley eye was modified according to participant’s intraocular lengths and anterior cornea curvature. Ray-tracing was performed at each angle through the stop, altering cornea asphericity until peripheral astigmatism matched experimental measurements. Retinal curvature and hence retinal co-ordinate intersection with the chief ray were altered until sagittal refraction matched its measurement. b) PEL: Ray-tracing was performed at each angle through the anterior corneal centre of curvature of the Gullstrand-Emsley eye. Ignoring lens refraction, retinal co-ordinates relative to the fovea were determined from PEL and trigonometry. From sets of retinal co-ordinates, conic retinal shapes were fitted in terms of Rv and Q. Repeated-measures ANOVA were conducted on Rv and Q, and post hoc t-tests with Bonferroni correction were used to compare races. Results:In all racial groups both methods showed greater Rv for the horizontal than for the vertical meridian and greater Rv for myopes than emmetropes. Rv was greater in EA than in CA (P=0.02), with Rv for SA being intermediate and not significantly different from CA and EA. The PEL method provided larger Rv than the PR method: PEL: EA vs CA 87±13 vs 83±11 m-1 (H), 79±13 vs 72±14 m-1 (V); PR: EA vs CA 79±10 vs 67±10 m-1 (H), 71±17 vs 66±12 m-1 (V). Q did not vary significantly with race. Conclusions:Estimates of Rv, but not of Q, varied significantly with race. The greater Rv found in EA than in CA and the comparatively high prevalence rate of myopia in many Asian countries may be related.

Porous versus porthole fuel injection in a radical farming scramjet: A numerical analysis

Numerically computed engine performance of a nominally two-dimensional radical farming scramjet with porous (permeable C/C ceramic) and porthole fuel injection is presented. Inflow conditions with Mach number, stagnation pressure, and enthalpy of 6.44, 40.2MPa, and 4.31 MJ/kg respectively, and fuel/air equivalence ratio of 0.44 were maintained, along with engine geometry. Hydrogen fuel was injected at an axial location of 92.33mm downstream of the leading edge for each investigated injection method. Results from this study show that porous fuel injection results in enhanced mixing and combustion compared to porthole fuel injection. This is particularly evident within the first half of the combustion chamber where porous fuel injection resulted in mixing and combustion efficiencies of 76% and 63% respectively. At the same location, porthole fuel injection resulted in efficiencies respectively of 58% and 46%. Key mechanisms contributing to the observed improved performance were the formation of an attached oblique fuel injection shock and associated stronger shock-expansion train ingested by the engine, enhanced spreading of the fuel in all directions and a more rapidly growing mixing layer.

Porous fuel injection with oxygen enrichment in a viable scramjet engine

Oxygen enriched, porous fuel injection has been numerically investigated in this study with the aim of understanding mixing and combustion enhancements achievable in a viable scramjet engine. Four injection configurations were studied: a fuel only case, a pre-mixed case and two staged injection cases where fuel and oxidiser were injected independently. All simulations were performed on a flight scale vehicle at Mach 8 flow conditions. Results show that the addition of oxygen with the fuel increases the mixing efficiency of the engine, however, is less sensitive to the method of oxygen addition: premixed versus staged. When the fuel-oxidiser-air mixture was allowed to combust, the method of additional oxygen delivery had a more significant impact. For pre-mixed fuel and oxidiser, the engine was found to choke, whereas in contrast, in the staged enrichment cases the engine failed to ignite. This result indicates that there exists an optimised configuration between pre-mixed and staged oxygen enrichment which results in a started, and combusting engine.

Numerical investigation of upstream fuel injection through porous media for scramjet engines via surrogate-assisted evolutionary algorithms

A multi-objective design optimization study has been conducted for upstream fuel injection through porous media applied to the first ramp of a two-dimensional scramjet intake. The optimization has been performed by coupling evolutionary algorithms assisted by surrogate modeling and computational fluid dynamics with respect to three design criteria, that is, the maximization of the absolute mixing quantity, total pressure saving, and fuel penetration. A distinct Pareto optimal front has been obtained, highlighting the counteracting behavior of the total pressure against the mixing efficiency and fuel penetration. The injector location and size have been identified as the key design parameters as a result of a sensitivity analysis, with negligible influence of the porous properties in the configurations and conditions considered in the present study. Flowfield visualization has revealed the underlying physics associated with the effects of these dominant parameters on the shock structure and intensity.

Transformerless PV inverters - recent test results and a discussion of DC current injection and safety issues

With the variety of PV inverter types and the number of transformerless PV inverters on the Australian market increasing, we revisit some of the issues associated with these topologies. A recent electric shock incident in Queensland (luckily without serious outcome) associated with a transformerless PV system, highlights the need for earthing PV array structures and PV module frames to prevent capacitive leakage currents causing electric shock. The presented test results of the relevant voltages associated with leakage currents of five transformerless PV inverters stress this requirement, which is currently being addressed by both the Clean Energy Council and Standards Australia. DC current injection tests were performed on the same five inverters and were used to develop preliminary recommendations for a more meaningful DC current test procedure for AS4777 Part 2. The test circuit, methodology and results are presented and discussed. A notable temperature dependency of DC current injections with three of the five inverters suggests that DC current injection should be tested at high and low internal inverter temperatures whereas the power dependency noted only for one inverter does not seem to justify recommendations for a (rather involved) standard test procedure at different power levels.

Methods to improve the energy output of dye sensitized solar cell arrays

The work examined the operation and optimisation of dye-sensitised solar cell arrays, informing ways to improve performance through materials choices and geometrical design. Methods to improve the output of solar arrays under shading by external objects like trees or building were developed.

Injection velocity control of thermoplastic injection molding via a double controller scheme

Injection velocity has been recognized as a key variable in thermoplastic injection molding. Its closed-loop control is, however, difficult due to the complexity of the process dynamic characteristics. The basic requirements of the control system include tracking of a pre-determined injection velocity curve defined in a profile, load rejection and robustness. It is difficult for a conventional control scheme to meet all these requirements. Injection velocity dynamics are first analyzed in this paper. Then a novel double-controller scheme is adopted for the injection velocity control. This scheme allows an independent design of set-point tracking and load rejection and has good system robustness. The implementation of the double-controller scheme for injection velocity control is discussed. Special techniques such as profile transformation and shifting are also introduced to improve the velocity responses. The proposed velocity control has been experimentally demonstrated to be effective for a wide range of processing conditions.

Statistical methods for electromyography data and associated problems

This thesis proposes three novel models which extend the statistical methodology for motor unit number estimation, a clinical neurology technique. Motor unit number estimation is important in the treatment of degenerative muscular diseases and, potentially, spinal injury. Additionally, a recent and untested statistic to enable statistical model choice is found to be a practical alternative for larger datasets. The existing methods for dose finding in dual-agent clinical trials are found to be suitable only for designs of modest dimensions. The model choice case-study is the first of its kind containing interesting results using so-called unit information prior distributions.

Public space for street-scape theatrics : guerrilla spatial tactics and methods of urban hacking in Brisbane, Australia

It could be argued that architecture has an inherent social responsibility to enrich the urban and spatial environments for the city’s occupants. However how we define quality, and how ‘places’ can be designed to be fair and equitable, catering for individuals on a humanistic and psychological level, is often not clearly addressed. Lefebvre discusses the idea of the ‘right to the city’; the belief that public space design should facilitate freedom of expression and incite a sense of spatial ownership for its occupants in public/commercial precincts. Lefebvre also points out the importance of sensory experience in the urban environment. “Street-scape theatrics” are performative activities that summarise these two concepts, advocating the ‘right to the city’ by way of art as well as providing sensual engagement for city users. Literature discusses the importance of Street-scape Theatrics however few sources attempt to discuss this topic in terms of how to design these spaces/places to enhance the city on both a sensory and political level. This research, grounded in political theory, investigates the case of street music, in particular busking, in the city of Brisbane, Australia. Street culture is a notion that already exists in Brisbane, but it is heavily controlled especially in central locations. The study discusses how sensory experience of the urban environment in Brisbane can be enriched through the design for busking; multiple case studies, interviews, observations and thematic mappings provide data to gather an understanding of how street performers see and understand the built form. Results are sometime surprisingly incongruous with general assumptions in regards to street artist as well as the established political and ideological framework, supporting the idea that the best and most effective way of urban hacking is working within the system. Ultimately, it was found that the Central Business District in Brisbane, Australia, could adopt certain political and design tactics which attempt to reconcile systematic quality control with freedom of expression into the public/commercial sphere, realism upheld. This can bridge the gap between the micro scale of the body and the macro of the political economy through freedom of expression, thus celebrating the idiosyncratic nature of the city.