Factors influencing the provision of end-of-life care in critical care settings : development and testing of a survey instrument

Aim. To develop and psychometrically test a survey instrument to identify the factors influencing the provision of end-of-life care by critical care nurses. Background. Following a decision to withdraw life-sustaining treatment, critical care nurses remain with the patient and their family providing end-of-life care. Identification of factors influencing the provision of this care can give evidence to inform practice development and support nurses. Design. A cross-sectional survey of critical care nurses. Method. An online survey was developed, reviewed by an expert panel and pilot tested to obtain preliminary evidence of its reliability and validity. In May 2011, a convenience sample of critical care nurses (n = 392, response rate 25%) completed the survey. The analytical approach to data obtained from the 58 items measured on a Likert scale included exploratory factor analysis and descriptive statistics. Results. Exploratory factor analysis identified eight factors influencing the provision of end-of-life care: emotional support for nurses, palliative values, patient and family preferences, resources, organizational support, care planning, knowledge and preparedness. Internal consistency of each latent construct was deemed satisfactory. The results of descriptive statistics revealed a strong commitment to the inclusion of families in end-of-life care and the value of this care in the critical care setting. Conclusion. This paper reports preliminary evidence of the psychometric properties of a new survey instrument. The findings may inform practice development opportunities to support critical care nurses in the provision of endof- life care and improve the care that patients and their families receive.

Bayesian networks for information synthesis in complex systems

This thesis introduces a method of applying Bayesian Networks to combine information from a range of data sources for effective decision support systems. It develops a set of techniques in development, validation, visualisation, and application of Complex Systems models, with a working demonstration in an Australian airport environment. The methods presented here have provided a modelling approach that produces highly flexible, informative and applicable interpretations of a system's behaviour under uncertain conditions. These end-to-end techniques are applied to the development of model based dashboards to support operators and decision makers in the multi-stakeholder airport environment. They provide highly flexible and informative interpretations and confidence in these interpretations of a system's behaviour under uncertain conditions.

Enhancing the auditor's report : to what extent is there support for the IAASB's proposed changes?

This article outlines proposed reforms to auditor reporting currently being considered by the International Auditing and Assurance Standards Board (IAASB), and other key national and transnational standard-setters and regulatory bodies. It adds to recent academic contributions on reforming the auditor’s report by analyzing the 165 stakeholder responses to the IAASB’s 2012 Invitation to Comment: Improving the Auditor’s Report to determine levels of support for the IAASB’s proposed reforms, and the differences, if any, between the views of various respondents based on stakeholder groups (e.g. audit and assurance firms, users, preparers, regulators, etc.) and regional classifications. Guided by insights from communication theory, our results show the levels of stakeholder support for the IAASB’s proposed reforms addressing auditors’ expectations, information and communication gaps are mixed. The strongest overall support was for enhanced auditor reporting on other information attached to, or intended to be read with, the financial statements, and the least supported initiative was including additional information in the auditor’s report about the auditor’s judgements and processes. Whilst overall there is generally consensus across both stakeholder groups and regions concerning the various questions investigated, we highlight where statistically significant differences between groups do exist. Notably, North American respondents were less likely to support a number of the IAASB’s proposed reforms than their counterparts from other regions.

Leadership to support quality improvement in Vietnamese higher education

The impetus for the study reported in this paper is the Higher Education (HE) reform agenda outlined by the Vietnamese Ministry of Education and Training (MOET). The paper reports on phase one of a mixed method research; a quantitative approach using the Multifactor Leadership Questionnaire (MLQ) to investigate the Vietnamese HE leaders’ leadership styles. The MLQ survey was administered to approximately 190 senior managers in State HE institutions in Mekong Delta region in Vietnam (nine of colleges). The psychometrics of the MLQ for the Vietnamese sample confirmed the reliability and validity of the instrument with a Cronbach’s alpha of 0.779. A CFA was conducted and all factor structures were stable and consistent. The demographic variables were used to analyse patterns of leadership behaviours by the different sub-groups. The findings suggest that leaders who have different educational background and different gender in Mekong Delta region, Vietnam do not differ significantly in their perceptions about leadership factors.

Refactoring Service Interface to Support Artefact-centric Service interaction

The growth of APIs and Web services on the Internet, especially through larger enterprise systems increasingly being leveraged for Cloud and software-as-a-service opportunities, poses challenges for improving the efficiency of integration with these services. Interfaces of enterprise systems are typically larger, more complex and overloaded, with single operations having multiple data entities and parameter sets, supporting varying requests, and reflecting versioning across different system releases, compared to fine-grained operations of contemporary interfaces. We propose a technique to support the refactoring of service interfaces by deriving business entities and their relationships. In this paper, we focus on the behavioural aspects of service interfaces, aiming to discover the sequential dependencies of operations (otherwise known as protocol extraction) based on the entities and relationships derived. Specifically, we propose heuristics according to these relationships, and in turn, deriving permissible orders in which operations are invoked. As a result of this, service operations can be refactored on business entity CRUD lines, with explicit behavioural protocols as part of an interface definition. This supports flexible service discovery, composition and integration. A prototypical implementation and analysis of existing Web services, including those of commercial logistic systems (Fedex), are used to validate the algorithms proposed through the paper.

Summarising and reporting sugarcane locomotive run statistics from TOTools and GPS data

The majority of sugar mill locomotives are equipped with GPS devices from which locomotive position data is stored. Locomotive run information (e.g. start times, run destinations and activities) is electronically stored in software called TOTools. The latest software development allows TOTools to interpret historical GPS information by combining this data with run information recorded in TOTools and geographic information from a GIS application called MapInfo. As a result, TOTools is capable of summarising run activity details such as run start and finish times and shunt activities with great accuracy. This paper presents 15 reports developed to summarise run activities and speed information. The reports will be of use pre-season to assist in developing the next year's schedule and for determining priorities for investment in the track infrastructure. They will also be of benefit during the season to closely monitor locomotive run performance against the existing schedule.

When sex doesn't sell: Using sexualized images of women reduces support for ethical campaigns

Images of scantily clad women are used by advertisers to make products more attractive to men. This ‘‘sex sells’’ approach is increasingly employed to promote ethical causes, most prominently by the animal-rights organization PETA. Yet sexualized images can dehumanize women, leaving an unresolved paradox – is it effective to advertise an ethical cause using unethical means? In Study 1, a sample of Australian male undergraduates (N = 82) viewed PETA advertisements containing either sexualized or non-sexualized images of women. Intentions to support the ethical organization were reduced for those exposed to the sexualized advertising, and this was explained by their dehumanization of the sexualized women, and not by increased arousal. Study 2 used a mixed-gender community sample from the United States (N = 280), replicating this finding and extending it by showing that behaviors helpful to the ethical cause diminished after viewing the sexualized advertisements, which was again mediated by the dehumanization of the women depicted. Alternative explanations relating to the reduced credibility of the sexualized women and their objectification were not supported. When promoting ethical causes, organizations may benefit from using advertising strategies that do not dehumanize women.

Emotional effort and perceived support in renal nursing: A comparative interview study

Background: Social support is an important moderator of poor well-being outcomes for nurses engaged in emotional labour with patients; however, the most effective support for renal nurses is not well understood compared with other specialties. Objectives: To identify patterns and themes in how renal nurses and two other specialties engage with patients’ emotional expressions, express their own emotion and access and provide support for emotional expenditure. Method: Renal, emergency and palliative care nurses from Perth, Western Australia, were interviewed. Results: Renal nurses engage in significant amounts of emotional labour with patients, and identify co-workers as the most important source of support due to their availability and a sense of shared experience. However, comparative analysis showed that renal nurses do not recognise their emotional expenditure as readily and have less certainty of co-worker support. Conclusions: Because their high levels of emotional engagement with patients are mostly positive, renal nurses are less prepared than other nurses to manage difficult emotional situations. As co-worker support is highly valued, organisations should train renal nurses specifically to support one another.

Developing and evaluating approaches for utilising injury data to support product safety initiatives

With increasing concern about consumer product-related injuries in Australia, product safety regulators need evidence-based research to understand risks and patterns to inform their decision making. This study analysed paediatric injury data to identify and quantify product-related injuries in children to inform product safety prioritisation. This study provides information on novel techniques for interrogating health data to identify trends and patterns in product-related injuries to inform strategic directions in this growing area of concern.

Multi-parametric hydrogels support 3D in vitro bioengineered microenvironment models of tumour angiogenesis

Tumour microenvironment greatly influences the development and metastasis of cancer progression. The development of three dimensional (3D) culture models which mimic that displayed in vivo can improve cancer biology studies and accelerate novel anticancer drug screening. Inspired by a systems biology approach, we have formed 3D in vitro bioengineered tumour angiogenesis microenvironments within a glycosaminoglycan-based hydrogel culture system. This microenvironment model can routinely recreate breast and prostate tumour vascularisation. The multiple cell types cultured within this model were less sensitive to chemotherapy when compared with two dimensional (2D) cultures, and displayed comparative tumour regression to that displayed in vivo. These features highlight the use of our in vitro culture model as a complementary testing platform in conjunction with animal models, addressing key reduction and replacement goals of the future. We anticipate that this biomimetic model will provide a platform for the in-depth analysis of cancer development and the discovery of novel therapeutic targets.

Fibroin-based materials support co-cultivation of limbal epithelial and stromal cells

The silk protein fibroin (Bombyx mori) provides a potential substrate for use in ocular tissue reconstruction. We have previously demonstrated that transparent membranes produced from fibroin support cultivation of human limbal epithelial (HLE) cells (Tissue Eng A. 14(2008)1203-11). We extend this body of work to studies of human limbal stromal cell (HLS) growth on fibroin in the presence and absence of serum. Also, we investigate the ability to produce a bi-layered composite scaffold of fibroin with an upper HLE layer and lower HLS layer.

Self-regulation support through music

A critical dimension of early learning competence in the year prior to school is self-regulation. Self-regulation enables children to manage their emotions and direct their attention, thinking, and actions to meet adaptive goals. These skills enhance young children's readiness to learn.

How do experts think about statistics? Hints for improving undergraduate and postgraduate training

Experts are increasingly being called upon to quantify their knowledge, particularly in situations where data is not yet available or of limited relevance. In many cases this involves asking experts to estimate probabilities. For example experts, in ecology or related fields, might be called upon to estimate probabilities of incidence or abundance of species, and how they relate to environmental factors. Although many ecologists undergo some training in statistics at undergraduate and postgraduate levels, this does not necessarily focus on interpretations of probabilities. More accurate elicitation can be obtained by training experts prior to elicitation, and if necessary tailoring elicitation to address the expert’s strengths and weaknesses. Here we address the first step of diagnosing conceptual understanding of probabilities. We refer to the psychological literature which identifies several common biases or fallacies that arise during elicitation. These form the basis for developing a diagnostic questionnaire, as a tool for supporting accurate elicitation, particularly when several experts or elicitors are involved. We report on a qualitative assessment of results from a pilot of this questionnaire. These results raise several implications for training experts, not only prior to elicitation, but more strategically by targeting them whilst still undergraduate or postgraduate students.

Evaluation of ANPR trials for traffic policing in Queensland. Report to the Queensland Police Service, State Traffic Support Branch

In response to the Travelsafe Committee Report No. 51 – report on the inquiry into Automatic Plate Recognition Technology – it was recommended that the Queensland Police Service continue to trial the deployment of ANPR technology for traffic enforcement work and to evaluate the road safety impacts and operational effectiveness of the technology. As such, the purpose of this report is to provide an independent evaluation of a trial of ANPR that was conducted by a project team within the State Traffic Support Branch of the Queensland Police Service (QPS) and provide recommendations as to the applicability and usability of the technology for use throughout Queensland...

A neurofuzzy approach to future intelligent driver support systems

This paper reviews a variety of advanced signal processing algorithms that have been developed at the University of Southampton as part of the Prometheus (PROgraMme for European Traffic flow with Highest Efficiency and Unprecedented Safety) research programme to achieve an intelligent driver warning system (IDWS). The IDWS includes: visual detection of both generic obstacles and other vehicles, together with their tracking and identification, estimates of time to collision and behavioural modelling of drivers for a variety of scenarios. These application areas are used to show the applicability of neurofuzzy techniques to the wide range of problems required to support an IDWS, and for future fully autonomous vehicles.