Evidence of disagreement between patient-perceived change and conventional longitudinal evaluation of change in health-related quality of life among older adults

Objective: To identify agreement levels between conventional longitudinal evaluation of change (post–pre) and patient-perceived change (post–then test) in health-related quality of life. Design: A prospective cohort investigation with two assessment points (baseline and six-month follow-up) was implemented. Setting: Community rehabilitation setting. Subjects: Frail older adults accessing community-based rehabilitation services. Intervention: Nil as part of this investigation. Main measures: Conventional longitudinal change in health-related quality of life was considered the difference between standard EQ-5D assessments completed at baseline and follow-up. To evaluate patient-perceived change a ‘then test’ was also completed at the follow-up assessment. This required participants to report (from their current perspective) how they believe their health-related quality of life was at baseline (using the EQ-5D). Patient-perceived change was considered the difference between ‘then test’ and standard follow-up EQ-5D assessments. Results: The mean (SD) age of participants was 78.8 (7.3). Of the 70 participants 62 (89%) of data sets were complete and included in analysis. Agreement between conventional (post–pre) and patient-perceived (post–then test) change was low to moderate (EQ-5D utility intraclass correlation coefficient (ICC)¼0.41, EQ-5D visual analogue scale (VAS) ICC¼0.21). Neither approach inferred greater change than the other (utility P¼0.925, VAS P¼0.506). Mean (95% confidence interval (CI)) conventional change in EQ-5D utility and VAS were 0.140 (0.045,0.236) and 8.8 (3.3,14.3) respectively, while patient-perceived change was 0.147 (0.055,0.238) and 6.4 (1.7,11.1) respectively. Conclusions: Substantial disagreement exists between conventional longitudinal evaluation of change in health-related quality of life and patient-perceived change in health-related quality of life (as measured using a then test) within individuals.

Longitudinal investigation of wandering behavior in department of veterans affairs nursing home care units

Objectives To explore the extent of and factors associated with male residents who change wandering status post nursing home admission. Design Longitudinal design with secondary data analyses. Admissions over a 4-year period were examined using repeat assessments with the Minimum Data Set (MDS) to formulate a model understanding the development of wandering behavior. Setting One hundred thirty-four Veterans Administration (VA) nursing homes throughout the United States. Participants: Included 6673 residents admitted to VA nursing homes between October 2000 and October 2004. Measurements MDS variables (cognitive impairment, mood, behavior problems, activities of daily living and wandering) included ratings recorded at residents’ admission to the nursing home and a minimum of two other time points at quarterly intervals. Results The majority (86%) of the sample were classified as non wanderers at admission and most of these (94%) remained non wanderers until discharge or the end of the study. Fifty one per cent of the wanderers changed status to non wanderers with 6% of these residents fluctuating in status more than two times. Admission variables associated with an increased risk of changing status from non-wandering to wandering included older age, greater cognitive impairment, more socially inappropriate behavior, resisting care, easier distractibility, and needing less help with personal hygiene. Requiring assistance with locomotion and having three or more medical comorbidities were associated with a decreased chance of changing from non-wandering to wandering status. Conclusion A resident’s change from non-wandering to wandering status may reflect an undetected medical event that affects cognition, but spares mobility.

Tips for generating a media release and media coverage : how the media ate up my research on Aussie horror movies

The focus of this paper is preparing research for dissemination by mainstream print, broadcast, and online media. While the rise of the blogosphere and social media is proving an effective way of reaching niche audiences, my own research reached such an audience through traditional media. The first major study of Australian horror cinema, my PhD thesis A Dark New World: Anatomy of Australian Horror Films, generated strong interest from horror movie fans, film scholars, and filmmakers. I worked closely with the Queensland University of Technology’s (QUT) public relations unit to write two separate media releases circulated on October 13, 2008 and October 14, 2009. This chapter reflects upon the process of working with the media and provides tips for reaching audiences, particularly in terms of strategically planning outcomes. It delves into the background of my study which would later influence my approach to the media, the process of drafting media releases, and key outcomes and benefits from popularising research. A key lesson from this experience is that redeveloping research for the media requires a sharp writing style, letting go of academic justification, catchy quotes, and an ability to distil complex details into easy-to-understand concepts. Although my study received strong media coverage, and I have since become a media commentator, my experiences also revealed a number of pitfalls that are likely to arise for other researchers keen on targeting media coverage.

Physical function and health-related quality of life of older adults undergoing hospital rehabilitation : how strong is the association?

The purpose of this research is to report preliminary empirical evidence regarding the association between common physical performance measures and health-related quality of life (HRQoL) of hospitalized older adults recovering from illness and injury. Frequently, these patients do not return to premorbid levels of independence and physical ability. Rehabilitation for this population often focuses on improving physical functioning and mobility with the intention of maximizing their HRQoL for discharge and thereafter. For this reason, longitudinal use of physical performance measures as an indicator of improvement in physical functioning (and thus HRQoL) is common. Although this is a logical approach, there have been mixed results from previous investigations into the association between common measures of physical function and HRQoL amongst other adult patient populations.1,2 There has been no previous investigation reporting the association between HRQoL and a variety of common physical performance measures in hospitalized older adults.

Getting research data ‘out there’ : collaborative solutions to identifying, describing and making research data more visible

At QUT research data refers to information that is generated or collected to be used as primary sources in the production of original research results, and which would be required to validate or replicate research findings (Callan, De Vine, & Baker, 2010). Making publicly funded research data discoverable by the broader research community and the public is a key aim of the Australian National Data Service (ANDS). Queensland University of Technology (QUT) has been innovating in this space by undertaking mutually dependant technical and content (metadata) focused projects funded by ANDS. Research Data Librarians identified and described datasets generated from Category 1 funded research at QUT, by interviewing researchers, collecting metadata and fashioning metadata records for upload to the Australian Research Data commons (ARDC) and exposure through the Research Data Australia interface. In parallel to this project, a Research Data Management Service and Metadata hub project were being undertaken by QUT High Performance Computing & Research Support specialists. These projects will collectively store and aggregate QUT’s metadata and research data from multiple repositories and administration systems and contribute metadata directly by OAI-PMH compliant feed to RDA. The pioneering nature of the work has resulted in a collaborative project dynamic where good data management practices and the discoverability and sharing of research data were the shared drivers for all activity. Each project’s development and progress was dependent on feedback from the other. The metadata structure evolved in tandem with the development of the repository and the development of the repository interface responded to meet the needs of the data interview process. The project environment was one of bottom-up collaborative approaches to process and system development which matched top-down strategic alliances crossing organisational boundaries in order to provide the deliverables required by ANDS. This paper showcases the work undertaken at QUT, focusing on the Seeding the Commons project as a case study, and illustrates how the data management projects are interconnected. It describes the processes and systems being established to make QUT research data more visible and the nature of the collaborations between organisational areas required to achieve this. The paper concludes with the Seeding the Commons project outcomes and the contribution this project made to getting more research data ‘out there’.

It really is black and white when you look at it like this : reporting on a study into Australian professors' research and teaching priorities

Despite optimistic claims about the research-teaching nexus, Australian academics still face tension between research and teaching. The teaching and research priorities, beliefs and behaviours of 70 Professorial and Associate Professorial academics in Science, Information Technology and Engineering were examined in this study. The academics from 4 faculties in 3 Australian universities, were asked to rank 16 research activities and 16 matched learning and teaching (L&T) activities from each of three perspectives: job satisfaction, leadership behaviour, and perceptions of professional importance. The findings, which were remarkably consistent across the three universities, were unequivocally in favour of Research. The only L&T activity that was ranked consistently well was “Improving student satisfaction ratings for Teaching”. The data demonstrates that Australian government and university initiatives to raise the status of L&T activity are not impacting significantly on Australia’s future leaders of university learning.

Design and implementation of sensor networks for the observation and research of harmful algal blooms in southern California coastal waters

Harmful Algal Blooms (HABs) have become an important environmental concern along the western coast of the United States. Toxic and noxious blooms adversely impact the economies of coastal communities in the region, pose risks to human health, and cause mortality events that have resulted in the deaths of thousands of fish, marine mammals and seabirds. One goal of field-based research efforts on this topic is the development of predictive models of HABs that would enable rapid response, mitigation and ultimately prevention of these events. In turn, these objectives are predicated on understanding the environmental conditions that stimulate these transient phenomena. An embedded sensor network (Fig. 1), under development in the San Pedro Shelf region off the Southern California coast, is providing tools for acquiring chemical, physical and biological data at high temporal and spatial resolution to help document the emergence and persistence of HAB events, supporting the design and testing of predictive models, and providing contextual information for experimental studies designed to reveal the environmental conditions promoting HABs. The sensor platforms contained within this network include pier-based sensor arrays, ocean moorings, HF radar stations, along with mobile sensor nodes in the form of surface and subsurface autonomous vehicles. FreewaveTM radio modems facilitate network communication and form a minimally-intrusive, wireless communication infrastructure throughout the Southern California coastal region, allowing rapid and cost-effective data transfer. An emerging focus of this project is the incorporation of a predictive ocean model that assimilates near-real time, in situ data from deployed Autonomous Underwater Vehicles (AUVs). The model then assimilates the data to increase the skill of both nowcasts and forecasts, thus providing insight into bloom initiation as well as the movement of blooms or other oceanic features of interest (e.g., thermoclines, fronts, river discharge, etc.). From these predictions, deployed mobile sensors can be tasked to track a designated feature. This focus has led to the creation of a technology chain in which algorithms are being implemented for the innovative trajectory design for AUVs. Such intelligent mission planning is required to maneuver a vehicle to precise depths and locations that are the sites of active blooms, or physical/chemical features that might be sources of bloom initiation or persistence. The embedded network yields high-resolution, temporal and spatial measurements of pertinent environmental parameters and resulting biology (see Fig. 1). Supplementing this with ocean current information and remotely sensed imagery and meteorological data, we obtain a comprehensive foundation for developing a fundamental understanding of HAB events. This then directs labor- intensive and costly sampling efforts and analyses. Additionally, we provide coastal municipalities, managers and state agencies with detailed information to aid their efforts in providing responsible environmental stewardship of their coastal waters.

Frank and Stein : from research scientist to creative writer (a screenplay and exegesis)

The screenplay, “Perfect Blood” (Frank and Stein), is the first two-hour episode of a two-part television miniseries Frank and Stein. This creative work is a science fiction story that speculates on the future of Western nations in a world where petroleum is scarce. A major theme that has been explored in the miniseries is the tension between the advantages and dangers of scientific progress without regard to human consequences. “Perfect Blood” (Frank and Stein) was written as part of my personal creative journey, which has been the transformation from research scientist to creative writer. In the exegetical component of this thesis, I propose that a key challenge for any scientist writing science fiction is the shift from conducting empirical research in a laboratory-based situation to engaging in creative practice research. During my personal creative journey, I found that a predominant difficulty in conducting research within a creative practice-led paradigm was unleashing my creativity and personal viewpoint, practices that are frowned upon in scientific research. The aim of the exegesis is to demonstrate that the transformative process from science to art is not neat and well-structured. My personal creative journey was fraught with many ‘wrong’ turns. However, after reflecting on the experience, I realise that every varied piece of research that I undertook allowed me to progress to the next stage, the next draft of Frank and Stein. And via the disorder of the creative process, a screenplay finally emerged that was both structured and creative, which are equally essential elements in screenwriting.

Nurse-led telephone interventions for people with cardiac disease : A review of the research literature

Background: Nurse-led telephone follow-up offers a relatively inexpensive method of delivering education and support for assisting recovery in the early discharge period; however, its efficacy is yet to be determined. Aim: To perform a critical integrative review of the research literature addressing the effectiveness of nurse-led telephone interventions for people with coronary heart disease (CHD). Methods: A literature search of five health care databases; Sciencedirect, Cumulative Index to Nursing and Allied Health Literature, Pubmed, Proquest and Medline to identify journal articles between 1980 and 2009. People with cardiac disease were considered for inclusion in this review. The search yielded 128 papers, of which 24 met the inclusion criteria. Results: A total of 8330 participants from 24 studies were included in the final review. Seven studies demonstrated statistically significant differences in all outcomes measured, used two group experimental research design and valid and reliable instruments. Some positive effects were detected in eight studies in regards to nurse-led telephone interventions for people with cardiac disease and no differences were detected in nine studies. Discussion: Studies with some positive effects generally had stronger research designs, large samples, used valid and reliable instruments and extensive nurse-led educative interventions. Conclusion: The results suggest that people with cardiac disease showed some benefits from nurse-led/delivered telephone interventions. More rigorous research into this area is needed.

Book review : Kellett, M (2010) Rethinking children and research : attitudes in contemporary society

Rethinking Children and Research characterizes Mary Kellett’s vision as campaigner and sociologist actively working for and with children for many years. The book itself is not only visionary; it is informative, thought provoking and pragmatic. From a contemporary standpoint, the manuscript presents a detailed synopsis of the shifts in thinking about research with children and provides an appraisal of the theoretical movements that have driven a participatory research agenda. A strong theoretical approach of the combined lenses of sociologies of childhood and rights discourse is introduced early in the book. From the outset, the reader receives loud and clear, the key message of the book: that children in research should and can be included as competent members who lead research in the study of their everyday lives. The argument for a more mutual research approach is shaped throughout the book using research examples and practical suggestions on how this might be achieved. Overall, the reader is left feeling compelled to adopt such an approach.

Sequential development of algebra knowledge : a cognitive analysis

Learning to operate algebraically is a complex process that is dependent upon extending arithmetic knowledge to the more complex concepts of algebra. Current research has shown a gap between arithmetic and algebraic knowledge and suggests a pre-algebraic level as a step between the two knowledge types. This paper examines arithmetic and algebraic knowledge from a cognitive perspective in an effort to determine what constitutes a pre-algebraic level of understanding. Results of a longitudinal study designed to investigate students' readiness for algebra are presented. Thirty-three students in Grades 7, 8, and 9 participated. A model for the transition from arithmetic to pre-algebra to algebra is proposed and students' understanding of relevant knowledge is discussed.

Establishing Aboriginal health research priorities in Victoria

The Victorian Aboriginal Community Controlled Health Organisation (VACCHO) conducted a research project to find out the impact of social determinants such as education, employment, income, racism and housing on the health and wellbeing of Aboriginal peoples. Forums and workshops were conducted to establish future research outcomes and priorities. The project will help in developing localised and community-oriented solutions to Aboriginal health issues.

Research report. A subtropical urban community. Investigating medium to high density residential typologies. Findings and recommendations from the Design Charrette

In June 2009 the Centre for Subtropical Design at the Queensland University of Technology conducted a design charrette to research design concepts for liveable subtropical neighbourhoods characterised by higher-density, mixed-use, family orientated housing. Subsequent analysis of the proposed designs evaluated how well these typologies support economic, environmental and social sustainability. The study was led by Ms Rosemary Kennedy, Director of the Centre for Subtropical Design and QUT School of Design Adjunct Professor Peter Richards, Chair of the Centre for Subtropical Design Board and director of Deicke Richards Architects and Urban Designers.

Research Ethics and Creative Arts Hypothetical

The merits of a research project are commonly framed in terms of perceived benefits with respect to knowledge production, wellbeing, the social good, and so on. Such measures can, however, be at odds with certain types of creative practice, which may be perceived as frivolous, unsettling, or shocking. Moreover, creative practice research methodologies commonly eschew more traditional research conventions. In exploring these tensions, this live performance event (including a DVD component) adapted key dramatic principles developed in Geoffrey Robertson's groundbreaking Hypotheticals. The event was presented for an audience of staff and students at QUT's Creative Industries Faculty in July 2010. It confirmed Dr Angela Romano's contention that: “Part of the ethical clearance process for practice-led researchers will be to find a language to explain the methodology, significance, merit and integrity of their research to people outside their field of practice.” (Angela Romano, QUT Creative Industries) “Part of the ethical clearance process for practice-led researchers will be to find a language to explain the methodology, significance, merit and integrity of their research to people outside their field of practice.”