Development and validation of a novel approach to work sampling : a study of nurse practitioner work patterns

Objectives: This methodological paper reports on the development and validation of a work sampling instrument and data collection processes to conduct a national study of nurse practitioners’ work patterns. ---------- Design: Published work sampling instruments provided the basis for development and validation of a tool for use in a national study of nurse practitioner work activities across diverse contextual and clinical service models. Steps taken in the approach included design of a nurse practitioner-specific data collection tool and development of an innovative web-based program to train and establish inter rater reliability of a team of data collectors who were geographically dispersed across metropolitan, rural and remote health care settings. ---------- Setting: The study is part of a large funded study into nurse practitioner service. The Australian Nurse Practitioner Study is a national study phased over three years and was designed to provide essential information for Australian health service planners, regulators and consumer groups on the profile, process and outcome of nurse practitioner service. ---------- Results: The outcome if this phase of the study is empirically tested instruments, process and training materials for use in an international context by investigators interested in conducting a national study of nurse practitioner work practices. ---------- Conclusion: Development and preparation of a new approach to describing nurse practitioner practices using work sampling methods provides the groundwork for international collaboration in evaluation of nurse practitioner service.

Australia and New Zealand CBNG development and environmental implications

Following the success of Coalbed Natural Gas (CBNG) operations in the United States, companies in Australia and New Zealand have been actively exploring and developing this technology for the last two decades. In particular, the Bowen and Surat basins in Queensland, Australia, have undergone extensive CBNG development. Unfortunately, awareness of potential environmental problems associated with CBNG abstraction has not been widespread and legislation has at times struggled to keep up with rapid development. In Australia, the combined CBNG resource for both the Bowen and Surat basins has been estimated at approximately 10,500 PJ with gas content as high as 10 m3/tonne of coal. There are no official estimates for the magnitude of the CBNG resource in New Zealand but initial estimates suggest this could be up to 1,300 PJ with gas content ranging from 1 to 5 m3/tonne of coal. In Queensland, depressurization of the Walloon Coal Measures to recover CBNG has the potential to induce drawdown in adjacent deep aquifer systems through intraformational groundwater flow. In addition, CBNG operators have been disposing their co-produced water by using large unlined ponds, which is not the best practice for managing co-produced water. CBNG waters in Queensland have the typical geochemical signature associated with CBNG waters (Van Voast, 2003) and thus have the potential to impair soils and plant growth where land disposal is considered. Water quality from exploration wells in New Zealand exhibit the same characteristics although full scale production has not yet begun. In general, the environmental impacts that could arise from CBNG water extraction depend on the aquifer system, the quantity and quality of produced water, and on the method of treatment and disposal being used. Understanding these impacts is necessary to adequately manage CBNG waters so that environmental effects are minimized; if properly managed, CBNG waters can be used for beneficial applications and can become a valuable resource to stakeholders.

An extended measure of work-life balance culture : development and confirmation of the measure

This paper extends the work of Thompson, Beauvais and Lyness (1999) to develop a more comprehensive measure of work-life balance culture. Thompson et al. developed a survey based on three sub-dimensions which examine work-family culture. We have extended this to incorporate extra dimensions, and to broaden the measure to encompass life aspects beyond the family. Two studies were conducted in order to test and refine the measure. Over 700 participants in the first study completed the survey, and the Confirmatory Factor Analysis results show that the extended measure is robust. Further, a second study with a sample of 629 participants confirmed the general measure, with slight adaptations. The results are discussed in relation to the use of the measure for work-life balance research.

The role of nature-based experiences in the development and maintenance of wellness

Wellness is now seen as central to redefining the National Health agenda. There is growing evidence that contact with nature and physical activity in nature has considerable positive effects on human health. At the most basic level humanity is reliant on the natural world for resources such as air and water. However, a growing body of research is finding that beyond this fundamental relationship exposure to the non-human natural world can also positively enhance perceptions of physiological, emotional, psychological and spiritual health in ways that cannot be satisfied by alternate means. Theoretical explanations for this have posited that non-human nature might 1) restore mental fatigue, 2) trigger deep reflections, 3) provide an opportunity for nurturing and 4) rekindle innate connections. In this paper the authors show how human wellness is strongly connected to their relationship with the natural world. This paper points to how non-human nature could be better utilised for enhancing human health and wellness.

Evaluating sustainability of urban development and its contribution to a knowledge-base development

Purpose – The purpose of the paper is to discuss the components of urban sustainability as to their implications about knowledge-base economy and society Design/methodology/approach – An indexing model which can be used by the local government specifically in Australia is presented to generate sustainable urban development policies. The model consists of sustainable neighbourhood indicators and employs a spatial indexing method to measure the sustainability performance of the urban settings Originality/value – This methodology puts in evidence about the use of indexing methodology in the assessment of sustainable neighbourhood performance Practical implications – This model could be considered as a practical decision aid tool for local government planning agencies for the evaluation of development scenarios Keywords – knowledge-based urban development, sustainable urban development, sustainable transport, sustainability assessment Paper type – Academic Research Paper

The development and validation of two complementary measures of drivers' hazard perception ability

Hazard perception in driving involves a number of different processes. This paper reports the development of two measures designed to separate these processes. A Hazard Perception Test was developed to measure how quickly drivers could anticipate hazards overall, incorporating detection, trajectory prediction, and hazard classification judgements. A Hazard Change Detection Task was developed to measure how quickly drivers can detect a hazard in a static image regardless of whether they consider it hazardous or not. For the Hazard Perception Test, young novices were slower than mid-age experienced drivers, consistent with differences in crash risk, and test performance correlated with scores in pre-existing Hazard Perception Tests. For drivers aged 65 and over, scores on the Hazard Perception Test declined with age and correlated with both contrast sensitivity and a Useful Field of View measure. For the Hazard Change Detection Task, novices responded quicker than the experienced drivers, contrary to crash risk trends, and test performance did not correlate with measures of overall hazard perception. However for drivers aged 65 and over, test performance declined with age and correlated with both hazard perception and Useful Field of View. Overall we concluded that there was support for the validity of the Hazard Perception Test for all ages but the Hazard Change Detection Task might only be appropriate for use with older drivers.

Autonomous underwater vehicles: development and implementation of time and energy efficient trajectories

Autonomous underwater vehicles (AUVs) are increasingly used, both in military and civilian applications. These vehicles are limited mainly by the intelligence we give them and the life of their batteries. Research is active to extend vehicle autonomy in both aspects. Our intent is to give the vehicle the ability to adapt its behavior under different mission scenarios (emergency maneuvers versus long duration monitoring). This involves a search for optimal trajectories minimizing time, energy or a combination of both. Despite some success stories in AUV control, optimal control is still a very underdeveloped area. Adaptive control research has contributed to cost minimization problems, but vehicle design has been the driving force for advancement in optimal control research. We look to advance the development of optimal control theory by expanding the motions along which AUVs travel. Traditionally, AUVs have taken the role of performing the long data gathering mission in the open ocean with little to no interaction with their surroundings, MacIver et al. (2004). The AUV is used to find the shipwreck, and the remotely operated vehicle (ROV) handles the exploration up close. AUV mission profiles of this sort are best suited through the use of a torpedo shaped AUV, Bertram and Alvarez (2006), since straight lines and minimal (0 deg - 30 deg) angular displacements are all that are necessary to perform the transects and grid lines for these applications. However, the torpedo shape AUV lacks the ability to perform low-speed maneuvers in cluttered environments, such as autonomous exploration close to the seabed and around obstacles, MacIver et al. (2004). Thus, we consider an agile vehicle capable of movement in six degrees of freedom without any preference of direction.

Parents resourcing children’s early development and learning

Parents deal with a complex web of choices when seeking and using knowledge and resources related to their young children’s literacy development. Information about children’s learning and development comes in many forms and is produced by an increasingly diverse range of players including governments, nongovernment organisations and commercial businesses. This study used a survey, interview and artefact collection to investigate mothers’ and fathers’ reported activities in seeking, accessing, producing and circulating information and resources related to children’s learning and development. Differences were found relating to parent gender and level of education. Parents’ resourcing activities are also shaped by their particular goals for their children.

Development and validation of a pregnancy symptoms inventory

BACKGROUND. Physical symptoms are common in pregnancy and are predominantly associated with normal physiological changes. These symptoms have a social and economic cost, leading to absenteeism from work and additional medical interventions. There is currently no simple method for identifying common pregnancy related problems in the antenatal period. A validated tool, for use by pregnancy care providers would be useful. AIM: The aim of the project was to develop and validate a Pregnancy Symptoms Inventory for use by healthcare professionals (HCPs). METHODS: A list of symptoms was generated via expert consultation with midwives and obstetrician gynaecologists. Focus groups were conducted with pregnant women in their first, second or third trimester. The inventory was then tested for face validity and piloted for readability and comprehension. For test-re-test reliability, it was administered to the same women 2 to 3 days apart. Finally, outpatient midwives trialled the inventory for 1 month and rated its usefulness on a 10cm visual analogue scale (VAS). The number of referrals to other health care professionals was recorded during this month. RESULTS: Expert consultation and focus group discussions led to the generation of a 41-item inventory. Following face validity and readability testing, several items were modified. Individual item test re-test reliability was between .51 to 1 with the majority (34 items) scoring .0.70. During the testing phase, 211 surveys were collected in the 1 month trial. Tiredness (45.5%), poor sleep (27.5%) back pain (19.5%) and nausea (12.6%) were experienced often. Among the women surveyed, 16.2% claimed to sometimes or often be incontinent. Referrals to the incontinence nurse increased > 8 fold during the study period. The median rating by midwives of the ‘usefulness’ of the inventory was 8.4 (range 0.9 to 10). CONCLUSIONS: The Pregnancy Symptoms Inventory (PSI) was well accepted by women in the 1 month trial and may be a useful tool for pregnancy care providers and aids clinicians in early detection and subsequent treatment of symptoms. It shows promise for use in the research community for assessing the impact of lifestyle intervention in pregnancy.

Development and pilot test of a peer-support based Cardiac-Diabetes Self-Management program : a study protocol

Background: People with cardiac disease and type 2 diabetes have higher hospital readmission rates (22%)compared to those without diabetes (6%). Self-management is an effective approach to achieve better health outcomes; however there is a lack of specifically designed programs for patients with these dual conditions. This project aims to extend the development and pilot test of a Cardiac-Diabetes Self-Management Program incorporating user-friendly technologies and the preparation of lay personnel to provide follow-up support. Methods/Design: A randomised controlled trial will be used to explore the feasibility and acceptability of the Cardiac-Diabetes Self-Management Program incorporating DVD case studies and trained peers to provide follow-up support by telephone and text-messaging. A total of 30 cardiac patients with type 2 diabetes will be randomised, either to the usual care group, or to the intervention group. Participants in the intervention group will received the Cardiac-Diabetes Self-Management Program in addition to their usual care. The intervention consists of three faceto- face sessions as well as telephone and text-messaging follow up. The face-to-face sessions will be provided by a trained Research Nurse, commencing in the Coronary Care Unit, and continuing after discharge by trained peers. Peers will follow up patients for up to one month after discharge using text messages and telephone support. Data collection will be conducted at baseline (Time 1) and at one month (Time 2). The primary outcomes include self-efficacy, self-care behaviour and knowledge, measured by well established reliable tools. Discussion: This paper presents the study protocol of a randomised controlled trial to pilot evaluates a Cardiac- Diabetes Self-Management program, and the feasibility of incorporating peers in the follow-ups. Results of this study will provide directions for using such mode in delivering a self-management program for patients with both cardiac condition and diabetes. Furthermore, it will provide valuable information of refinement of the intervention program.

Submission to Victorian Parliamentary Committee on Economic Development and Infrastructure

In the networked information driven world that we now inhabit the ability to access and reuse information, data and culture is a key ingredient to social, economic and cultural innovation. As government holds enormous amounts of publicly funded material that can be released to the public without breaching the law it should move to implement policies that will allow better access to and reuse of that information, knowledge and culture. The Queensland Government Information Licensing Framework (GILF) Project4 is one of the first projects in the world to systemically approach this issue and should be consulted as a best practice model.

Development and evaluation of an integrated clinical learning model to inform continuing education for acute care nurses

Background Significant ongoing learning needs for nurses have occurred as a direct result of the continuous introduction of technological innovations and research developments in the healthcare environment. Despite an increased worldwide emphasis on the importance of continuing education, there continues to be an absence of empirical evidence of program and session effectiveness. Few studies determine whether continuing education enhances or develops practice and the relative cost benefits of health professionals’ participation in professional development. The implications for future clinical practice and associated educational approaches to meet the needs of an increasingly diverse multigenerational and multicultural workforce are also not well documented. There is minimal research confirming that continuing education programs contribute to improved patient outcomes, nurses’ earlier detection of patient deterioration or that standards of continuing competence are maintained. Crucially, evidence-based practice is demonstrated and international quality and safety benchmarks are adhered to. An integrated clinical learning model was developed to inform ongoing education for acute care nurses. Educational strategies included the use of integrated learning approaches, interactive teaching concepts and learner-centred pedagogies. A Respiratory Skills Update education (ReSKU) program was used as the content for the educational intervention to inform surgical nurses’ clinical practice in the area of respiratory assessment. The aim of the research was to evaluate the effectiveness of implementing the ReSKU program using teaching and learning strategies, in the context of organisational utility, on improving surgical nurses’ practice in the area of respiratory assessment. The education program aimed to facilitate better awareness, knowledge and understanding of respiratory dysfunction in the postoperative clinical environment. This research was guided by the work of Forneris (2004), who developed a theoretical framework to operationalise a critical thinking process incorporating the complexities of the clinical context. The framework used educational strategies that are learner-centred and participatory. These strategies aimed to engage the clinician in dynamic thinking processes in clinical practice situations guided by coaches and educators. Methods A quasi experimental pre test, post test non–equivalent control group design was used to evaluate the impact of the ReSKU program on the clinical practice of surgical nurses. The research tested the hypothesis that participation in the ReSKU program improves the reported beliefs and attitudes of surgical nurses, increases their knowledge and reported use of respiratory assessment skills. The study was conducted in a 400 bed regional referral public hospital, the central hub of three smaller hospitals, in a health district servicing the coastal and hinterland areas north of Brisbane. The sample included 90 nurses working in the three surgical wards eligible for inclusion in the study. The experimental group consisted of 36 surgical nurses who had chosen to attend the ReSKU program and consented to be part of the study intervention group. The comparison group included the 39 surgical nurses who elected not to attend the ReSKU program, but agreed to participate in the study. Findings One of the most notable findings was that nurses choosing not to participate were older, more experienced and less well educated. The data demonstrated that there was a barrier for training which impacted on educational strategies as this mature aged cohort was less likely to take up educational opportunities. The study demonstrated statistically significant differences between groups regarding reported use of respiratory skills, three months after ReSKU program attendance. Between group data analysis indicated that the intervention group’s reported beliefs and attitudes pertaining to subscale descriptors showed statistically significant differences in three of the six subscales following attendance at the ReSKU program. These subscales included influence on nursing care, educational preparation and clinical development. Findings suggest that the use of an integrated educational model underpinned by a robust theoretical framework is a strong factor in some perceptions of the ReSKU program relating to attitudes and behaviour. There were minimal differences in knowledge between groups across time. Conclusions This study was consistent with contemporary educational approaches using multi-modal, interactive teaching strategies and a robust overarching theoretical framework to support study concepts. The construct of critical thinking in the clinical context, combined with clinical reasoning and purposeful and collective reflection, was a powerful educational strategy to enhance competency and capability in clinicians.

Development and validation of a questionnaire designed to measure foot-health status

The aim of this study was to apply the principles of content, criterion, and construct validation to a new questionnaire specifically designed to measure foot-health status. One hundred eleven subjects completed two different questionnaires designed to measure foot health (the new Foot Health Status Questionnaire and the previously validated Foot Function Index) and underwent a clinical examination in order to provide data for a second-order confirmatory factor analysis. Presented herein is a psychometrically evaluated questionnaire that contains 13 items covering foot pain, foot function, footwear, and general foot health. The tool demonstrates a high degree of content, criterion, and construct validity and test-retest reliability.