Context-sensitive evaluation: Determining the context surrounding the implementation of a government policy

This article explains the essence of the context-sensitive parameters and dimensions in play at the time of an intervention, through the application of Rog’s (2012) model of contextual parameters. Rog’s model offers evaluators a structured approach to examine an intervention. The initial study provided a systematic way to clarify the scope, variables, timing, and appropriate evaluation methodology to evaluate the implementation of a government policy. Given that the government implementation of an educational intervention under study did not follow the experimental research approach, nor the double cycle of action research approach, the application of Rog’s model provided an in-depth understanding of the context-sensitive environment; it is from this clear purpose that the broader evaluation was conducted. Overall, when governments or institutions implement policy to invoke educational change (and this intervention is not guided by an appropriate evaluation approach), then program evaluation is achievable post-implementation. In this situation, Rog’s (2012) model of contextual parameters is a useful way to achieve clarity of purpose to guide the program evaluation.

Understanding the determinants of Australian hospital nurses' hand hygiene decisions following the implementation of a national hand hygiene initiative

Hand hygiene is the primary measure in hospitals to reduce the spread of infections, with nurses experiencing the greatest frequency of patient contact. The ‘5 critical moments’ of hand hygiene initiative has been implemented in hospitals across Australia, accompanied by awareness-raising, staff training and auditing. The aim of this study was to understand the determinants of nurses’ hand hygiene decisions, using an extension of a common health decision-making model, the theory of planned behaviour (TPB), to inform future health education strategies to increase compliance. Nurses from 50 Australian hospitals (n = 2378) completed standard TPB measures (attitude, subjective norm, perceived behavioural control [PBC], intention) and the extended variables of group norm, risk perceptions (susceptibility, severity) and knowledge (subjective, objective) at Time 1, while a sub-sample (n = 797) reported their hand hygiene behaviour 2 weeks later. Regression analyses identified subjective norm, PBC, group norm, subjective knowledge and risk susceptibility as the significant predictors of nurses’ hand hygiene intentions, with intention and PBC predicting their compliance behaviour. Rather than targeting attitudes which are already very favourable among nurses, health education strategies should focus on normative influences and perceptions of control and risk in efforts to encourage hand hygiene adherence.

Evaluation of the implementation of the prostate cancer specialist nurse role

A national prostate cancer specialist nursing pilot program, supported by Prostate Cancer Foundation of Australia, was launched in May 2012 with funding support from The Movember Foundation. The pilot program aimed to trial a best practice model for providing specialist nursing care to those affected by prostate cancer. Prostate cancer specialist nurses were allocated to 12 hospitals across all Australian states and territories to work in the context of multidisciplinary care. The Prostate Cancer Foundation provided professional development support for nurses through a structured program. This article presents key outcomes from the research commissioned by the Prostate Cancer Foundation to evaluate the prostate cancer specialist nurse role. Specifically, the paper reports evaluation data relating to the roles and functions of the prostate cancer specialist nurse to explore the influence of the role on outcomes for patients, carers and services.

Development of an EMR implementation framework for public hospitals in Saudi Arabia

An Electronic Medical Record (EMR) is a system that has been embraced by healthcare providers worldwide. However, the implementation success of EMRs has varied widely. Studies have identified both barriers to and facilitators for implementing EMRs within healthcare organisations. In Saudi Arabia (SA), the majority of healthcare providers manage patient records manually. As public hospitals are a major provider of health services in SA and have been shown to face more EMR implementation barriers than private hospitals, there is a need for an implementation framework to guide EMR implementation in Saudi public hospitals. This doctoral project therefore aimed to develop an evidence-based EMR implementation framework for public hospitals in SA informed by those who work at the micro-implementation level and the macro-implementation level and the extant literature sensitive to the cultural, resource-related, and technological, organisational, and environmental issues of SA.

Implementation of parallel tridiagonal solvers for a heterogeneous computing environment

Tridiagonal diagonally dominant linear systems arise in many scientific and engineering applications. The standard Thomas algorithm for solving such systems is inherently serial forming a bottleneck in computation. Algorithms such as cyclic reduction and SPIKE reduce a single large tridiagonal system into multiple small independent systems which can be solved in parallel. We have developed portable cyclic reduction and SPIKE algorithm OpenCL implementations with the intent to target a range of co-processors in a heterogeneous computing environment including Field Programmable Gate Arrays (FPGAs), Graphics Processing Units (GPUs) and other multi-core processors. In this paper, we evaluate these designs in the context of solver performance, resource efficiency and numerical accuracy.

Principles to guide sustainable implementation of extended-scope-of-practice physiotherapy workforce redesign initiatives in Australia: Stakeholder perspectives, barriers, supports, and incentives

Sustainable implementation of new workforce redesign initiatives requires strategies that minimize barriers and optimize supports. Such strategies could be provided by a set of guiding principles. A broad understanding of the concerns of all the key stakeholder groups is required before effective strategies and initiatives are developed. Many new workforce redesign initiatives are not underpinned by prior planning, and this threatens their uptake and sustainability. This study reports on a cross-sectional qualitative study that sought the perspectives of representatives of key stakeholders in a new workforce redesign initiative (extended-scope-of-practice physiotherapy) in one Australian tertiary hospital. The key stakeholder groups were those that had been involved in some way in the development, management, training, funding, and/or delivery of the initiative. Data were collected using semistructured questions, answered individually by interview or in writing. Responses were themed collaboratively, using descriptive analysis. Key identified themes comprised: the importance of service marketing; proactively addressing barriers; using readily understood nomenclature; demonstrating service quality and safety, monitoring adverse events, measuring health and cost outcomes; legislative issues; registration; promoting viable career pathways; developing, accrediting, and delivering a curriculum supporting physiotherapists to work outside of the usual scope; and progression from "a good idea" to established service. Health care facilities planning to implement new workforce initiatives that extend scope of usual practice should consider these issues before instigating workforce/model of care changes. © 2014 Morris et al.

Post-deposition ageing reactions of plasma derived polyterpenol thin films

Owing to the structural flexibility, uncomplicated processing and manufacturing capabilities, plasma polymers are the subject of active academic as well as industrial research. Polymer thin films prepared from non-synthetic monomers combine desirable optical and physical properties with biocompatibility and environmental sustainability. However, the ultimate expediency and implementation of such materials will dependent on the stability of these properties under varied environmental conditions. Polyterpenol thin films were manufactured at different deposition powers. Under ambient conditions, the bulk of ageing occurred within first 150h after deposition and was attributed to oxidation and volumetric relaxation. Films observed for further 12 months showed no significant changes in thickness or refractive index. Thermal degradation behaviour indicated thermal stability increased for the films manufactured at higher RF powers. Annealing the films to 405°C resulted in full degradation, with retention between 0.29 and 0.99%, indicating films' potential as sacrificial material.

Fabrication and characterization of plasma polymer thin films from monoterpene alcohols for applications in organic electronics and biotechnology

After more than twenty years of basic and applied research, the use of nanotechnology in the design and manufacture of nanoscale materials is rapidly increasing, particularly in commercial applications that span from electronics across renewable energy areas, and biomedical devices. Novel polymers are attracting significant attention for they promise to provide a low−cost high−performance alternative to existing materials. Furthermore, these polymers have the potential to overcome limitations imposed by currently available materials thus enabling the development of new technologies and applications that are currently beyond our reach. This work focuses on the development of a range of new low−cost environmentally−friendly polymer materials for applications in areas of organic (flexible) electronics, optics, and biomaterials. The choice of the monomer reflects the environmentally−conscious focus of this project. Terpinen−4−ol is a major constituent of Australian grown Melaleuca alternifolia (tea tree) oil, attributed with the oil's antimicrobial and anti−inflammatory properties. Plasma polymerisation was chosen as a deposition technique for it requires minimal use of harmful chemicals and produces no hazardous by−products. Polymer thin films were fabricated under varied process conditions to attain materials with distinct physico−chemical, optoelectrical, biological and degradation characteristics. The resultant materials, named polyterpenol, were extensively characterised using a number of well−accepted and novel techniques, and their fundamental properties were defined. Polyterpenol films were demonstrated to be hydrocarbon rich, with variable content of oxygen moieties, primarily in the form of hydroxyl and carboxyl functionalities. The level of preservation of original monomer functionality was shown to be strongly dependent on the deposition energy, with higher applied power increasing the molecular fragmentation and substrate temperature. Polyterpenol water contact angle contact angle increased from 62.7° for the 10 W samples to 76.3° for the films deposited at 100 W. Polymers were determined to resist solubilisation by water, due to the extensive intermolecular and intramolecular hydrogen bonds present, and other solvents commonly employed in electronics and biomedical processing. Independent of deposition power, the surface topography of the polymers was shown to be smooth (Rq <0.5 nm), uniform and defect free. Hardness of polyterpenol coatings increased from 0.33 GPa for 10 W to 0.51 GPa for 100 W (at 500 μN load). Coatings deposited at higher input RF powers showed less mechanical deformation during nanoscratch testing, with no considerable damage, cracking or delamination observed. Independent of the substrate, the quality of film adhesion improved with RF power, suggesting these coatings are likely to be more stable and less susceptible to wear. Independent of fabrication conditions, polyterpenol thin films were optically transparent, with refractive index approximating that of glass. Refractive index increased slightly with deposition power, from 1.54 (10 W) to 1.56 (100 W) at 500 nm. The optical band gap values declined with increasing power, from 2.95 eV to 2.64 eV, placing the material within the range for semiconductors. Introduction of iodine impurity reduced the band gap of polyterpenol, from 2.8 eV to 1.64 eV, by extending the density of states more into the visible region of the electromagnetic spectrum. Doping decreased the transparency and increased the refractive index from 1.54 to 1.70 (at 500 nm). At optical frequencies, the real part of permittivity (k) was determined to be between 2.34 and 2.65, indicating a potential low-k material. These permittivity values were confirmed at microwave frequencies, where permittivity increased with input RF energy – from 2.32 to 2.53 (at 10 GHz ) and from 2.65 to 2.83 (at 20 GHz). At low frequencies, the dielectric constant was determined from current−voltage characteristics of Al−polyterpenol−Al devices. At frequencies below 100 kHz, the dielectric constant varied with RF power, from 3.86 to 4.42 at 1 kHz. For all samples, the resistivity was in order of 10⁸−10⁹ _m (at 6 V), confirming the insulating nature of polyterpenol material. In situ iodine doping was demonstrated to increase the conductivity of polyterpenol, from 5.05 × 10⁻⁸ S/cm to 1.20 × 10⁻⁶ S/cm (at 20 V). Exposed to ambient conditions over extended period of time, polyterpenol thin films were demonstrated to be optically, physically and chemically stable. The bulk of ageing occurred within first 150 h after deposition and was attributed to oxidation and volumetric relaxation. Thermal ageing studies indicated thermal stability increased for the films manufactured at higher RF powers, with degradation onset temperature associated with weight loss shifting from 150 ºC to 205 ºC for 10 W and 100 W polyterpenol, respectively. Annealing the films to 405 °C resulted in full dissociation of the polymer, with minimal residue. Given the outcomes of the fundamental characterisation, a number of potential applications for polyterpenol have been identified. Flexibility, tunable permittivity and loss tangent properties of polyterpenol suggest the material can be used as an insulating layer in plastic electronics. Implementation of polyterpenol as a surface modification of the gate insulator in pentacene-based Field Effect Transistor resulted in significant improvements, shifting the threshold voltage from + 20 V to –3 V, enhancing the effective mobility from 0.012 to 0.021 cm²/Vs, and improving the switching property of the device from 10⁷ to 10⁴. Polyterpenol was demonstrated to have a hole transport electron blocking property, with potential applications in many organic devices, such as organic light emitting diodes. Encapsulation of biomedical devices is also proposed, given that under favourable conditions, the original chemical and biological functionality of terpinen−4−ol molecule can be preserved. Films deposited at low RF power were shown to successfully prevent adhesion and retention of several important human pathogens, including P. aeruginosa, S. aureus, and S. epidermidis, whereas films deposited at higher RF power promoted bacterial cell adhesion and biofilm formation. Preliminary investigations into in vitro biocompatibility of polyterpenol demonstrated the coating to be non−toxic for several types of eukaryotic cells, including Balb/c mice macrophage and human monocyte type (HTP−1 non-adherent) cells. Applied to magnesium substrates, polyterpenol encapsulating layer significantly slowed down in vitro biodegradation of the metal, thus increasing the viability and growth of HTP−1 cells. Recently, applied to varied nanostructured titanium surfaces, polyterpenol thin films successfully reduced attachment, growth, and viability of P. aeruginosa and S. aureus.

Best practice full-stop: Anticipating the spillover effects of enterprise education

This paper considers the potential flow-on benefits that may arise from the increasing provision of enterprise education. The issue of vulnerability is proposed to be a factor associated with superior learning outcomes. Therefore, this paper aims to highlight the use of student and facilitator vulnerability to increase the capacity for learning in Higher Education. It is argued that students benefit from having to struggle to find their identity within a learning environment. That group work can assist the development of confidence through which improved learning behaviours are adopted. Also, the development of good learning practices in the domain of enterprise education have the potential to aid student learning outcomes in other areas of study. This paper provides another means of valuing the potential gains to be received from enterprise education.

Organisational culture and quality management system implementation in Indonesian construction companies

The study of the organisational culture in the construction industry is still in the stage of debate (Oney-Yazıcı et al., 2007). Despite the complexities involved in measuring the culture of the construction industry (Tijhuis and Fellows, 2012), this culture is regarded as being worthy of research, especially in relation to the organisational culture needed to support quality management systems (Koh and Low, 2008; Watson and Howarth, 2011) and to improve organisational effectiveness, and therefore, organisational performance (Coffey, 2010; Cheung et al., 2011). A number of recent studies have examined the construction companies’ organisational culture within the context of the use of Cameron and Quinn’s Competing Value Framework (CVF), as well as the use of their Organizational Culture Assessment Instrument (OCAI) as the conceptual paradigm for the analyses (Thomas et al., 2002; Nummelin, 2006; Oney- Yazıcı et al., 2007; Koh and Low, 2008). However, there has been little research based on the use of Cameron and Quinn’s CVF-OCAI tool for identifying types of construction companies’ organisational culture and their influences on the implementation of QMS-ISO 9001. Research output and information is also very limited relating to the strength of the companies’ organisational culture driving an effective QMS-ISO 9001 implementation, affecting the companies’ effectiveness. To rectify these research gaps, the research has been aimed to study organisational culture types (based on CVF) and their influences on the implementation of QMS-ISO 9001:2008 principles and elements, which eventually lead to improved companies’ quality performance. In order to fully examine the status of the QMS being implemented, the research has studied the relationships of the barriers of QMS implementation with the implementation of QMS-ISO 9001:2008 principles and elements and with the business performance of the companies, as well as the examination of the relationships of the implementation of QMS-ISO 9001:2008 principles and elements with the companies’ business performance. The research output has been the development of fundamental and original studies on the study topics, to provide the knowledge for improvements in Indonesian construction companies’ quality performance and quality outcomes.

The effectiveness of the teach-back method on adherence and self-management in health education for people with chronic disease: A systematic review

- BACKGROUND Chronic diseases are increasing worldwide and have become a significant burden to those affected by those diseases. Disease-specific education programs have demonstrated improved outcomes, although people do forget information quickly or memorize it incorrectly. The teach-back method was introduced in an attempt to reinforce education to patients. To date, the evidence regarding the effectiveness of health education employing the teach-back method in improved care has not yet been reviewed systematically. - OBJECTIVES This systematic review examined the evidence on using the teach-back method in health education programs for improving adherence and self-management of people with chronic disease. - INCLUSION CRITERIA Types of participants: Adults aged 18 years and over with one or more than one chronic disease. Types of intervention: All types of interventions which included the teach-back method in an education program for people with chronic diseases. The comparator was chronic disease education programs that did not involve the teach-back method. Types of studies: Randomized and non-randomized controlled trials, cohort studies, before-after studies and case-control studies. Types of outcomes: The outcomes of interest were adherence, self-management, disease-specific knowledge, readmission, knowledge retention, self-efficacy and quality of life. - SEARCH STRATEGY Searches were conducted in CINAHL, MEDLINE, EMBASE, Cochrane CENTRAL, Web of Science, ProQuest Nursing and Allied Health Source, and Google Scholar databases. Search terms were combined by AND or OR in search strings. Reference lists of included articles were also searched for further potential references. - METHODOLOGICAL QUALITY Two reviewers conducted quality appraisal of papers using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument. - DATA EXTRACTION Data were extracted using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument data extraction instruments. - DATA SYNTHESIS There was significant heterogeneity in selected studies, hence a meta-analysis was not possible and the results were presented in narrative form. - RESULTS Of the 21 articles retrieved in full, 12 on the use of the teach-back method met the inclusion criteria and were selected for analysis. Four studies confirmed improved disease-specific knowledge in intervention participants. One study showed a statistically significant improvement in adherence to medication and diet among type 2 diabetics patients in the intervention group compared to the control group (p < 0.001). Two studies found statistically significant improvements in self-efficacy (p = 0.0026 and p < 0.001) in the intervention groups. One study examined quality of life in heart failure patients but the results did not improve from the intervention (p = 0.59). Five studies found a reduction in readmission rates and hospitalization but these were not always statistically significant. Two studies showed improvement in daily weighing among heart failure participants, and in adherence to diet, exercise and foot care among those with type 2 diabetes. - CONCLUSION Overall, the teach-back method showed positive effects in a wide range of health care outcomes although these were not always statistically significant. Studies in this systematic review revealed improved outcomes in disease-specific knowledge, adherence, self-efficacy and the inhaler technique. There was a positive but inconsistent trend also seen in improved self-care and reduction of hospital readmission rates. There was limited evidence on improvement in quality of life or disease related knowledge retention.

Theories of moral education and implementation in Indonesia: Re-energizing cultural identity and addressing future challenges

School is regarded as a site of moral training for the younger generation to encounter nation’s future challenges as well as to re-energize nation’s cultural identity. The more competitive global society led by free market trade in terms of ASEAN Economic Community (AEC), requires the school to adapt and change its curriculum more frequently. Like many other countries, Indonesian Ministry of Education and Culture has introduced and nurtured universal values and traditional values respectively through school curriculum reforms to develop students’ ability to participating in global society. This paper will describe classical and contemporary theories related to moral education that have been implemented in Indonesia’s school curriculum and school activities. The theories developed by Durkheim, Alastair MacIntyre, and Basil Bernstein will be discussed. This includes explaining how far the theories have been adopted in Indonesia and how the approaches are currently being used in Indonesian schooling. This paper suggests despite the implementation of those theories in Indonesian schools, the government needs to optimise the operation of those theories to gain significant outcomes.

Prevention and management of foot problems in diabetes: A summary guidance for daily practice 2015, based on the IWGDF Guidance Documents

In this 'Summary Guidance for Daily Practice', we describe the basic principles of prevention and management of foot problems in persons with diabetes. This summary is based on the International Working Group on the Diabetic Foot (IWGDF) Guidance 2015. There are five key elements that underpin prevention of foot problems: (1) identification of the at-risk foot; (2) regular inspection and examination of the at-risk foot; (3) education of patient, family and healthcare providers; (4) routine wearing of appropriate footwear, and; (5) treatment of pre-ulcerative signs. Healthcare providers should follow a standardized and consistent strategy for evaluating a foot wound, as this will guide further evaluation and therapy. The following items must be addressed: type, cause, site and depth, and signs of infection. There are seven key elements that underpin ulcer treatment: (1) relief of pressure and protection of the ulcer; (2) restoration of skin perfusion; (3) treatment of infection; (4) metabolic control and treatment of co-morbidity; (5) local wound care; (6) education for patient and relatives, and; (7) prevention of recurrence. Finally, successful efforts to prevent and manage foot problems in diabetes depend upon a well-organized team, using a holistic approach in which the ulcer is seen as a sign of multi-organ disease, and integrating the various disciplines involved.

Implementation of e-learning: A case study of three schools

As Western Australian schools move to implement technology into the classroom, there appears to be prevalence in combining e-learning with face to face traditional classroom practice. This has been accompanied by a shift toward a digital curriculum that incorporates re-usable learning objects. Essential to any teacher contemplating the use of a digital curriculum resource is not only the knowledge of learning theories but models of best practice to create online curriculum for students to use in every day classrooms. This paper explores the e-learning practices in three case study schools (n=3) in Western Australia. Data were collected by observation and interviews (n=11) conducted with the teachers and the ICT co-ordinators, to ascertain their perceptions and experiences with regard to the e-learning environment. There were challenges associated with the implementation of e-learning by teachers into their classroom such as skill development, changes in their role and the pedagogies they employ. The case study schools were pilot schools breaking new ground in order to test a new portal technology. Findings indicated that successful implementation of the e-learning environment was dependent on the four key factors of ICT infrastructure, ICT leadership, support and training initiatives and the teachers’ ICT capacity.

Are organisations prepared for e-health implementation to respond to pandemic influenza?

E-health can facilitate communication and interactions among stakeholders involved in pandemic responses. Its implementation, nevertheless, represents a disruptive change in the healthcare workplace. Organisational preparedness assessment is an essential requirement prior to e-health implementation; including this step in the planning process can increase the chances of programme success. The objective of this study is to develop an e-health preparedness assessment model for pandemic influenza (EHPM4P). Following the Analytic Hierarchy Process (AHP), 20 contextual interviews were conducted with domain experts from May to September 2010. We examined the importance of all preparedness components within a fivedimensional hierarchical framework that was recently published. We also calculated the relative weight for each component at all levels of the hierarchy. This paper presents the hierarchical model (EHPM4P) that can be used to precisely assess healthcare organisational and providers' preparedness for e-health implementation and potentially maximise e-health benefits in the context of an influenza pandemic. Copyright © 2013 Inderscience Enterprises Ltd.