The impact of perceived stage of cancer on carers’ anxiety and depression during the patients’ final year of life

Objective: This paper explores the effects of perceived stage of cancer (PSOC) on carers' anxiety and depression during the patients' final year. Methods: A consecutive sample of patients and carers (N=98) were surveyed at regular intervals regarding PSOC, and anxiety and depression using the Hospital Anxiety and Depression Scale. Means were compared by gender using the Mann-Whitney U-test. The chi-square was used to analyse categorical data. Agreement between carers' and patients' PSOC was estimated using kappa statistics. Correlations between carers' PSOC and their anxiety and depression were calculated using the Spearman's rank correlation. Results: Over time, an increasing proportion of carers reported that the cancer was advanced, culminating at 43% near death. Agreement regarding PSOC was fair (kappa=0.29-0.34) until near death (kappa=0.21). Carers' anxiety increased over the year; depression increased in the final 6 months. Females were more anxious (p=0.049, 6 months; p=0.009, 3 months) than males, and more depressed until 1 month to death. The proportion of carers reporting moderate-severe anxiety almost doubled over the year to 27%, with more females in this category at 6 months (p=0.05). Carers with moderate-severe depression increased from 6 to 15% over the year. Increased PSOC was weakly correlated with increased anxiety and depression. Conclusions: Carers' anxiety exceeded depression in severity during advanced cancer. Females generally experienced greater anxiety and depression. Carers were more realistic than patients regarding the ultimate outcome, which was reflected in their declining mental health, particularly near the end.

Whole of life cycle cost analysis in bridge rehabilitation

The report presents a methodology for whole of life cycle cost analysis of alternative treatment options for bridge structures, which require rehabilitation. The methodology has been developed after a review of current methods and establishing that a life cycle analysis based on a probabilistic risk approach has many advantages including the essential ability to consider variability of input parameters. The input parameters for the analysis are identified as initial cost, maintenance, monitoring and repair cost, user cost and failure cost. The methodology utilizes the advanced simulation technique of Monte Carlo simulation to combine a number of probability distributions to establish the distribution of whole of life cycle cost. In performing the simulation, the need for a powerful software package, which would work with spreadsheet program, has been identified. After exploring several products on the market, @RISK software has been selected for the simulation. In conclusion, the report presents a typical decision making scenario considering two alternative treatment options.

Traps for the unwary : reform stories of private sector managers entering public service

The purpose of this research is to capture and interpret the stories of “outsider” managers who make the transition to the public sector. These experiences are considered in the context of efforts to shift public management culture in a direction consistent with meeting contemporary demands placed on public sector organisations. It is often noted that an important strategy for changing culture is the infusion of outsiders. Outsiders are thought to bring new perspectives that, through a dialectical process (Van de Ven 1995), create the potential for change. While there have been cross-sector comparisons (Broussine 1990; Silfvast 1994; Redman 1997), little attention has been given to the experience of those who make the transition in the context of efforts to reform public sector management culture. Not only is the infusion of private sector managers into the public sector a potential culture change strategy, it is also a personal experience for those who make the transition. Boundary crossing is typically an anxiety provoking experience (Van Maanen & Schein 1979) and the quality of this experience influences decisions to commit, engage, disengage or exit. The quality of the experience is likely to be affected by how the public organisation responds to people making this transition, that is, their investment in people processing (Saks 2007). The cost of recruitment and selection processes at middle and senior management levels warrants a greater research focus on this transition. In this paper we argue that the experiences of those who make the transition from private to public sectors has much to tell us about the traps that transition managers experience in making this change, the implications for injecting outsider managers as a strategy for achieving public management culture change, and how reform-oriented public organisations can manage the transitions of outsider managers into the public sector in order that best value might be achieved for both the individual and organisational change goals.

Looking through the haze of discontent : smokers as a data source

In the case of industrial relations research, particularly that which sets out to examine practices within workplaces, the best way to study this real-life context is to work for the organisation. Studies conducted by researchers working within the organisation comprise some of the (broad) field’s classic research (cf. Roy, 1954; Burawoy, 1979). Participant and non-participant ethnographic research provides an opportunity to investigate workplace behaviour beyond the scope of questionnaires and interviews. However, we suggest that the data collected outside a workplace can be just as important as the data collected inside the organisation’s walls. In recent years the introduction of anti-smoking legislation in Australia has meant that people who smoke cigarettes are no longer allowed to do so inside buildings. Not only are smokers forced outside to engage in their habit, but they have to smoke prescribed distances from doorways, or in some workplaces outside the property line. This chapter considers the importance of cigarette-smoking employees in ethnographic research. Through data collected across three separate research projects, the chapter argues that smokers, as social outcasts in the workplace, can provide a wealth of important research data. We suggest that smokers also appear more likely to provide stories that contradict the ‘management’ or ‘organisational’ position. Thus, within the haze of smoke, researchers can uncover a level of discontent with the ‘corporate line’ presented inside the workplace. There are several aspects to the increased propensity of smokers to provide a contradictory or discontented story. It may be that the researcher is better able to establish a rapport with smokers, as there is a removal of the artificial wall a researcher presents as an outsider. It may also be that a research location physically outside the boundaries of the organisation provides workers with the freedom to express their discontent. The authors offer no definitive answers; rather, this chapter is intended to extend our knowledge of workplace research through highlighting the methodological value in using smokers as research subjects. We present the experience of three separate case studies where interactions with cigarette smokers have provided either important organisational data or alternatively a means of entering what Cunnison (1966) referred to as the ‘gossip circle’. The final section of the chapter draws on the evidence to demonstrate how the community of smokers, as social outcasts, are valuable in investigating workplace issues. For researchers and practitioners, these social outcasts may very well prove to be an important barometer of employee attitudes; attitudes that perhaps cannot be measured through traditional staff surveys.

Preliminary report on data mining techniques for life prediction

This project is an extension of a previous CRC project (220-059-B) which developed a program for life prediction of gutters in Queensland schools. A number of sources of information on service life of metallic building components were formed into databases linked to a Case-Based Reasoning Engine which extracted relevant cases from each source. In the initial software, no attempt was made to choose between the results offered or construct a case for retention in the casebase. In this phase of the project, alternative data mining techniques will be explored and evaluated. A process for selecting a unique service life prediction for each query will also be investigated. This report summarises the initial evaluation of several data mining techniques.

Final Report : learning system for life prediction of infrastructure

The project has further developed two programs for the industry partners related to service life prediction and salt deposition. The program for Queensland Department of Main Roads which predicts salt deposition on different bridge structures at any point in Queensland has been further refined by looking at more variables. It was found that the height of the bridge significantly affects the salt deposition levels only when very close to the coast. However the effect of natural cleaning of salt by rainfall was incorporated into the program. The user interface allows selection of a location in Queensland, followed by a bridge component. The program then predicts the annual salt deposition rate and rates the likely severity of the environment. The service life prediction program for the Queensland Department of Public Works has been expanded to include 10 common building components, in a variety of environments. Data mining procedures have been used to develop the program and increase the usefulness of the application. A Query Based Learning System (QBLS) has been developed which is based on a data-centric model with extensions to provide support for user interaction. The program is based on number of sources of information about the service life of building components. These include the Delphi survey, the CSIRO Holistic model and a school survey. During the project, the Holistic model was modified for each building component and databases generated for the locations of all Queensland schools. Experiments were carried out to verify and provide parameters for the modelling. These included instrumentation of a downpipe, measurements on pH and chloride levels in leaf litter, EIS measurements and chromate leaching from Colorbond materials and dose tests to measure corrosion rates of new materials. A further database was also generated for inclusion in the program through a large school survey. Over 30 schools in a range of environments from tropical coastal to temperate inland were visited and the condition of the building components rated on a scale of 0-5. The data was analysed and used to calculate an average service life for each component/material combination in the environments, where sufficient examples were available.

Citizen journalism and everyday life : A case study of Germany’s myHeimat.de

Much recent research into citizen journalism has focussed on its role in political debate and deliberation. Such research examines important questions about citizen participation in democratic processes – however, it perhaps places undue focus on only one area of journalistic coverage, and presents a challenge which only a small number of citizen journalism projects can realistically hope to meet. A greater opportunity for broad-based citizen involvement in journalistic activities may lie outside of politics, in the coverage of everyday community life. A leading exponent of this approach is the German-based citizen journalism Website myHeimat.de, which provides a nationwide platform for participants to contribute reports about events in their community. myHeimat takes a hyperlocal approach but also allows for content aggregation on specific topics across multiple local communities; Hannover-based newspaper publishing house Madsack has recently acquired a stake in the project. Drawing on extensive interviews with myHeimat CEO Martin Huber and Madsack newspaper editors Peter Taubald and Clemens Wlokas during October 2008, this paper analyses the myHeimat project and examines its applicability beyond rural and regional areas in Germany; it investigates the question of what role citizen journalism may play beyond the political realm.

Strategies for minimising the whole of life cycle cost of reinforced concrete bridge exposed to aggressive environments

n design of bridge structures, it is common to adopt a 100 year design life. However, analysis of a number of case study bridges in Australia has indicated that the actual design life can be significantly reduced due to premature deterioration resulting from exposure to aggressive environments. A closer analysis of the cost of rehabilitation of these structures has raised some interesting questions. What would be the real service life of a bridge exposed to certain aggressive environments? What is the strategy of conducting bridge rehabilitation? And what are the life cycle costs associated with rehabilitation? A research project funded by the CRC for Construction Innovation in Australia is aimed at addressing these issues. This paper presents a concept map for assisting decision makers to appropriately choose the best treatment for bridge rehabilitation affected by premature deterioration through exposure to aggressive environments in Australia. The decision analysis is referred to a whole of life cycle cost analysis by considering appropriate elements of bridge rehabilitation costs. In addition, the results of bridges inspections in Queensland are presented

Challenges in residual service life assessment for refurbishment

A need for an efficient life care management of building portfolio is becoming increasingly due to increase in aging building infrastructure globally. Appropriate structural engineering practices along with facility management can assist in optimising the remaining life cycle costs for existing public building portfolio. A more precise decision to either demolish, refurbish, do nothing or rebuilt option for any typical building under investigation is needed. In order to achieve this, the status of health of the building needs to be assessed considering several aspects including economic and supply-demand considerations. An investment decision for a refurbishment project competing with other capital works and/or refurbishment projects can be supported by emerging methodology residual service life assessment. This paper discusses challenges in refurbishment projects of public buildings and with a view towards development of residual service life assessment methodology

Re-life of buildings - decision support tools for maximising project efficiency

This paper describes the process adopted in developing an integrated decision support framework for planning of office building refurbishment projects, with specific emphasize on optimising rentable floor space, structural strengthening, residual life and sustainability. Expert opinion on the issues to be considered in a tool is being captured through the DELPHI process, which is currently ongoing. The methodology for development of the integrated tool will be validated through decisions taken during a case study project: refurbishment of CH1 building of Melbourne City Council, which will be followed through to completion by the research team. Current status of the CH1 planning will be presented in the context of the research project.

Defining reference service life : an open innovation approach

The endeavour to obtain estimates of durability of components for use in lifecycle assessment or costing and infrastructure and maintenance planning systems is large. The factor method and the reference service life concept provide a very valuable structure, but do not resolve the central dilemma of the need to derive an extensive database of service life. Traditional methods of estimating service life, such as dose functions or degradation models, can play a role in developing this database, however the scale of the problem clearly indicates that individual dose functions cannot be derived for each component in each different local and geographic setting. Thus, a wider range of techniques is required in order to devise reference service life. This paper outlines the approaches being taken in the Cooperative Research Centre for Construction Innovation project to predict reference service life. Approaches include the development of fundamental degradation and microclimate models, the development of a situation-based reasoning ‘engine’ to vary the ‘estimator’ of service life, and the development of a database on expert performance (Delphi study). These methods should be viewed as complementary rather than as discrete alternatives. As discussed in the paper, the situation-based reasoning approach in fact has the possibility of encompassing all other methods.