Improving statistical analysis of matched case-control studies

Matched case–control research designs can be useful because matching can increase power due to reduced variability between subjects. However, inappropriate statistical analysis of matched data could result in a change in the strength of association between the dependent and independent variables or a change in the significance of the findings. We sought to ascertain whether matched case–control studies published in the nursing literature utilized appropriate statistical analyses. Of 41 articles identified that met the inclusion criteria, 31 (76%) used an inappropriate statistical test for comparing data derived from case subjects and their matched controls. In response to this finding, we developed an algorithm to support decision-making regarding statistical tests for matched case–control studies.

Confirmatory factory analysis of the Neck Disability Index in a general problematic neck population indicates a one-factor model

BACKGROUND CONTEXT: The Neck Disability Index frequently is used to measure outcomes of the neck. The statistical rigor of the Neck Disability Index has been assessed with conflicting outcomes. To date, Confirmatory Factor Analysis of the Neck Disability Index has not been reported for a suitably large population study. Because the Neck Disability Index is not a condition-specific measure of neck function, initial Confirmatory Factor Analysis should consider problematic neck patients as a homogenous group. PURPOSE: We sought to analyze the factor structure of the Neck Disability Index through Confirmatory Factor Analysis in a symptomatic, homogeneous, neck population, with respect to pooled populations and gender subgroups. STUDY DESIGN: This was a secondary analysis of pooled data. PATIENT SAMPLE: A total of 1,278 symptomatic neck patients (67.5% female, median age 41 years), 803 nonspecific and 475 with whiplash-associated disorder. OUTCOME MEASURES: The Neck Disability Index was used to measure outcomes. METHODS: We analyzed pooled baseline data from six independent studies of patients with neck problems who completed Neck Disability Index questionnaires at baseline. The Confirmatory Factor Analysis was considered in three scenarios: the full sample and separate sexes. Models were compared empirically for best fit. RESULTS: Two-factor models have good psychometric properties across both the pooled and sex subgroups. However, according to these analyses, the one-factor solution is preferable from both a statistical perspective and parsimony. The two-factor model was close to significant for the male subgroup (p<.07) where questions separated into constructs of mental function (pain, reading headaches and concentration) and physical function (personal care, lifting, work, driving, sleep, and recreation). CONCLUSIONS: The Neck Disability Index demonstrated a one-factor structure when analyzed by Confirmatory Factor Analysis in a pooled, homogenous sample of neck problem patients. However, a two-factor model did approach significance for male subjects where questions separated into constructs of mental and physical function. Further investigations in different conditions, subgroup and sex-specific populations are warranted.

Information-theoretic analysis of brain white matter fiber orientation distribution functions

We propose a new information-theoretic metric, the symmetric Kullback-Leibler divergence (sKL-divergence), to measure the difference between two water diffusivity profiles in high angular resolution diffusion imaging (HARDI). Water diffusivity profiles are modeled as probability density functions on the unit sphere, and the sKL-divergence is computed from a spherical harmonic series, which greatly reduces computational complexity. Adjustment of the orientation of diffusivity functions is essential when the image is being warped, so we propose a fast algorithm to determine the principal direction of diffusivity functions using principal component analysis (PCA). We compare sKL-divergence with other inner-product based cost functions using synthetic samples and real HARDI data, and show that the sKL-divergence is highly sensitive in detecting small differences between two diffusivity profiles and therefore shows promise for applications in the nonlinear registration and multisubject statistical analysis of HARDI data.

The Australian litigation landscape - Oral and Maxillofacial Surgery and general dentistry (oral surgery procedures): An analysis of litigation cases

Background: There are persistent concerns about litigation in the dental and medical professions. These concerns arise in a setting where general dentists are more frequently undertaking a wider range of oral surgery procedures, potentially increasing legal risk. Methods: Judicial cases dealing with medical negligence in the fields of general dentistry (oral surgery procedure) and Oral and Maxillofacial Surgery were located using the three main legal databases. Relevant cases were analysed to determine the procedures involved, the patients’ claims of injury, findings of negligence, and damages awarded. A thematic analysis of the cases was undertaken to determine trends. Results: Fifteen cases over a twenty-year period were located across almost all Australian jurisdictions (eight cases involved general dentists; seven cases involved Oral and Maxillofacial Surgeons). Eleven of the fifteen cases involved determinations of whether or not the practitioner had failed in their duty of care; negligence was found in six cases. Eleven of the fifteen cases related to molar extractions (eight specifically to third molar). Conclusions: Dental and medical practitioners wanting to manage legal risk should have regard to circumstances arising in judicial cases. Adequate warning of risks is critical, as is offering referral in appropriate cases. Pre-operative radiographs, good medical records, and processes to ensure appropriate follow-up are also important.

A methodological approach to modelling design led innovation across secondary education : an Australian case study

Incorporating design thinking as a generic capability at a school level is needed to ensure future generations are empowered for business innovation and active citizenship. This paper describes the methodology of an investigation into modelling design led innovation approaches from the business sector to secondary education, as part of a larger study. It builds on a previously discussed research agenda by outlining the scope, significance and limitations of currently available research in this area, examining an action research methodology utilising an Australian design immersion program case study, and discussing implications and future work. It employs a triangulated approach encompassing thematic analysis of qualitative data collection from student focus groups, semi-structured convergent interviews with teachers and facilitators, and student journals. Eventual outcomes will be reviewed and analysed within the framework of a proposed innovation matrix model for educational growth, synthesising principles responding to 21st century student outcomes. It is anticipated this research will inform a successful design led secondary education innovation model, facilitating new engagement frameworks between tertiary and secondary education sectors, as well as providing new insight into the suitability of action research in prototyping social innovation in Australia.

Cloud computing adoption in Australia : the benefits, risks and implications for accounting

The purpose of this paper is to empirically examine the state of cloud computing adoption in Australia. I specifically focus on the drivers, risks, and benefits of cloud computing from the perspective of IT experts and forensic accountants. I use thematic analysis of interview data to answer the research questions of the study. The findings suggest that cloud computing is increasingly gaining foothold in many sectors due to its advantages such as flexibility and the speed of deployment. However, security remains an issue and therefore its adoption is likely to be selective and phased. Of particular concern are the involvement of third parties and foreign jurisdictions, which in the event of damage may complicate litigation and forensic investigations. This is one of the first empirical studies that reports on cloud computing adoption and experiences in Australia.

A happy compromise: Collaborative approaches to school library designing

Designing a school library is a complex, costly and demanding process with important educational and social implications for the whole school community. Drawing upon recent research, this paper presents contrasting snapshots of two school libraries to demonstrate the impacts of greater and lesser collaboration in the designing process. After a brief literature review, the paper outlines the research design (qualitative case study, involving collection and inductive thematic analysis of interview data and student drawings). The select findings highlight the varying experiences of each school’s teacher-librarian through the four designing phases of imagining, transitioning, experiencing and reimagining. Based on the study’s findings, the paper concludes that design outcomes are enhanced through collaboration between professional designers and key school stakeholders including teacher-librarians, teachers, principals and students. The findings and recommendations are of potential interest to teacher-librarians, school principals, education authorities, information professionals and library managers, to guide user-centred library planning and resourcing.

Knowledge transfer through a transnational program partnership between Indonesian and Australian universities

As transnational programs are often advocated as a knowledge transfer opportunity between the partner universities, this case study investigated the knowledge transfer (KT) processes between Indonesian and Australian universities through an undergraduate transnational program partnership (TPP). An inter-organisational KT theoretical framework from the business sector was adapted and used to guide the study. The data were generated through semi-structured interviews with key university officers and document analysis from two partner universities. Based on the thematic analysis of the data, the findings demonstrated that the curriculum mapping process facilitated KT. However, different intentions of the partner universities in establishing the program led to declining interest to conduct more KT when expectations were not met. The Indonesian university’s existing knowledge, acquired from other sources through processes that were serendipitous and based on individual lecturers’ personal experience, meant that KT opportunities through the TPP were not always pursued despite written agreement to exchange knowledge with the Australian partner. While KT most evidently resulted in institutional capacity development for the Indonesian university’s school that managed the TPP, dissemination of knowledge to other units within the university was more challenging due to communication problems between the units. Hence, other universities seeking to conduct KT through TPPs need to understand each partner university's intention in establishing the partnerships, identify the institutions' needs before seeking knowledge input from the partner university and improve the communication between and within the universities for sustainable benefits.

Preservice early childhood teachers and designers partnering for change at The Lone Pine Koala Sanctuary: An interdisciplinary education and design for sustainability project

This presentation discusses and critiques a current case study of a project in which Early Childhood preservice teachers are working in partnership with Design students to develop principles and concepts for the design and construction of an early childhood centre. This centre, to be built on the grounds of the iconic Lone Pine Koala Sanctuary in Brisbane , focuses on Education for Sustainability (EfS), sustainable design and sustainable business. Interdisciplinary initiatives between QUT staff and students from two Faculties (Education and Creative Industries) have been situated in the real –world context of this project. This practical, authentic project has seen stakeholders take an interdisciplinary approach to sustainability, opening up new ways of thinking about early childhood centre design, particularly with respect to operation and function. Interdisciplinarity and a commitment to genuine partnerships have created intellectual spaces to re-think the potential of the disciplines to be interwoven so that future professionals from different fields might come together to learn from each other and to address the sustainability imperative. The case study documents and explores the possibilities that the Lone Pine project offers for academics and students from Early Childhood and Design to collaboratively inform the Sanctuary’s vision for the Centre. The research examines how students benefit from practical, real world, community-integrated learning; how academic staff across two disciplines are able to work collaboratively within a real-world context; and how external stakeholders experience and benefit from the partnership with university staff and students. Data were collected via a series of focus group and individual interviews designed to explore how the various stakeholders (staff, students, business partners) experienced their involvement in the interdisciplinary project. Inductive and deductive thematic analysis of these data suggest many benefits for participants as well as a number of challenges. Findings suggest that the project has provided students with ‘real world’ partnerships that reposition early childhood students’ identities from ‘novice’ to ‘professional’, where their knowledge, expertise and perspectives are simultaneously validated and challenged in their work with designers. These partnerships are enabling preservice teachers to practice a new model of early childhood leadership in sustainability, one that is vital for leading for change in an increasingly complex world. This presentation celebrates, critiques and problematises this project, exploring wider implications for other contexts in which university staff and students may seek to work across traditional boundaries, thus building partnerships for change.

Pre-service early childhood teachers and designers partnering for change at The Lone Pine Koala Sanctuary: An interdisciplinary education and design for sustainability project

This presentation discusses and critiques a current case study of a project in which Early Childhood preservice teachers are working in partnership with Design students to develop principles and concepts for the design and construction of an early childhood centre. This centre, to be built on the grounds of the iconic Lone Pine Koala Sanctuary in Brisbane , focuses on Education for Sustainability (EfS), sustainable design and sustainable business. Interdisciplinary initiatives between QUT staff and students from two Faculties (Education and Creative Industries) have been situated in the real –world context of this project. This practical, authentic project has seen stakeholders take an interdisciplinary approach to sustainability, opening up new ways of thinking about early childhood centre design, particularly with respect to operation and function. Interdisciplinarity and a commitment to genuine partnerships have created intellectual spaces to re-think the potential of the disciplines to be interwoven so that future professionals from different fields might come together to learn from each other and to address the sustainability imperative. The case study documents and explores the possibilities that the Lone Pine project offers for academics and students from Early Childhood and Design to collaboratively inform the Sanctuary’s vision for the Centre. The research examines how students benefit from practical, real world, community-integrated learning; how academic staff across two disciplines are able to work collaboratively within a real-world context; and how external stakeholders experience and benefit from the partnership with university staff and students. Data were collected via a series of focus group and individual interviews designed to explore how the various stakeholders (staff, students, business partners) experienced their involvement in the interdisciplinary project. Inductive and deductive thematic analysis of these data suggest many benefits for participants as well as a number of challenges. Findings suggest that the project has provided students with ‘real world’ partnerships that reposition early childhood students’ identities from ‘novice’ to ‘professional’, where their knowledge, expertise and perspectives are simultaneously validated and challenged in their work with designers. These partnerships are enabling preservice teachers to practice a new model of early childhood leadership in sustainability, one that is vital for leading for change in an increasingly complex world. This presentation celebrates, critiques and problematises this project, exploring wider implications for other contexts in which university staff and students may seek to work across traditional boundaries, thus building partnerships for change.

Perception of prescription medicine sample packs among Australian professional, government, industry, and consumer organizations, based on automated textual analysis of one-on-one interviews

Background Prescription medicine samples provided by pharmaceutical companies are predominantly newer and more expensive products. The range of samples provided to practices may not represent the drugs that the doctors desire to have available. Few studies have used a qualitative design to explore the reasons behind sample use. Objective The aim of this study was to explore the opinions of a variety of Australian key informants about prescription medicine samples, using a qualitative methodology. Methods Twenty-three organizations involved in quality use of medicines in Australia were identified, based on the authors' previous knowledge. Each organization was invited to nominate 1 or 2 representatives to participate in semistructured interviews utilizing seeding questions. Each interview was recorded and transcribed verbatim. Leximancer v2.25 text analysis software (Leximancer Pty Ltd., Jindalee, Queensland, Australia) was used for textual analysis. The top 10 concepts from each analysis group were interrogated back to the original transcript text to determine the main emergent opinions. Results A total of 18 key interviewees representing 16 organizations participated. Samples, patient, doctor, and medicines were the major concepts among general opinions about samples. The concept drug became more frequent and the concept companies appeared when marketing issues were discussed. The Australian Pharmaceutical Benefits Scheme and cost were more prevalent in discussions about alternative sample distribution models, indicating interviewees were cognizant of budgetary implications. Key interviewee opinions added richness to the single-word concepts extracted by Leximancer. Conclusions Participants recognized that prescription medicine samples have an influence on quality use of medicines and play a role in the marketing of medicines. They also believed that alternative distribution systems for samples could provide benefits. The cost of a noncommercial system for distributing samples or starter packs was a concern. These data will be used to design further research investigating alternative models for distribution of samples.

Using automated text analysis to evaluate students’ conceptual understanding

Background: A major challenge for assessing students’ conceptual understanding of STEM subjects is the capacity of assessment tools to reliably and robustly evaluate student thinking and reasoning. Multiple-choice tests are typically used to assess student learning and are designed to include distractors that can indicate students’ incomplete understanding of a topic or concept based on which distractor the student selects. However, these tests fail to provide the critical information uncovering the how and why of students’ reasoning for their multiple-choice selections. Open-ended or structured response questions are one method for capturing higher level thinking, but are often costly in terms of time and attention to properly assess student responses. Purpose: The goal of this study is to evaluate methods for automatically assessing open-ended responses, e.g. students’ written explanations and reasoning for multiple-choice selections. Design/Method: We incorporated an open response component for an online signals and systems multiple-choice test to capture written explanations of students’ selections. The effectiveness of an automated approach for identifying and assessing student conceptual understanding was evaluated by comparing results of lexical analysis software packages (Leximancer and NVivo) to expert human analysis of student responses. In order to understand and delineate the process for effectively analysing text provided by students, the researchers evaluated strengths and weakness for both the human and automated approaches. Results: Human and automated analyses revealed both correct and incorrect associations for certain conceptual areas. For some questions, that were not anticipated or included in the distractor selections, showing how multiple-choice questions alone fail to capture the comprehensive picture of student understanding. The comparison of textual analysis methods revealed the capability of automated lexical analysis software to assist in the identification of concepts and their relationships for large textual data sets. We also identified several challenges to using automated analysis as well as the manual and computer-assisted analysis. Conclusions: This study highlighted the usefulness incorporating and analysing students’ reasoning or explanations in understanding how students think about certain conceptual ideas. The ultimate value of automating the evaluation of written explanations is that it can be applied more frequently and at various stages of instruction to formatively evaluate conceptual understanding and engage students in reflective

High body mass index is not a barrier to physical activity: Analysis of international rugby players' anthropometric data

Recent data indicate that levels of overweight and obesity are increasing at an alarming rate throughout the world. At a population level (and commonly to assess individual health risk), the prevalence of overweight and obesity is calculated using cut-offs of the Body Mass Index (BMI) derived from height and weight. Similarly, the BMI is also used to classify individuals and to provide a notional indication of potential health risk. It is likely that epidemiologic surveys that are reliant on BMI as a measure of adiposity will overestimate the number of individuals in the overweight (and slightly obese) categories. This tendency to misclassify individuals may be more pronounced in athletic populations or groups in which the proportion of more active individuals is higher. This differential is most pronounced in sports where it is advantageous to have a high BMI (but not necessarily high fatness). To illustrate this point we calculated the BMIs of international professional rugby players from the four teams involved in the semi-finals of the 2003 Rugby Union World Cup. According to the World Health Organisation (WHO) cut-offs for BMI, approximately 65% of the players were classified as overweight and approximately 25% as obese. These findings demonstrate that a high BMI is commonplace (and a potentially desirable attribute for sport performance) in professional rugby players. An unanswered question is what proportion of the wider population, classified as overweight (or obese) according to the BMI, is misclassified according to both fatness and health risk? It is evident that being overweight should not be an obstacle to a physically active lifestyle. Similarly, a reliance on BMI alone may misclassify a number of individuals who might otherwise have been automatically considered fat and/or unfit.