Implementation and evaluation of a new model of nursing practice in radiation oncology

Patients undergoing radiation therapy for cancer face a series of challenges that require support from a multidisciplinary team which includes radiation oncology nurses. However, the specific contribution of nursing, and the models of care that best support the delivery of nursing interventions in the radiotherapy setting, is not well described. In this case study, the Interaction Model of Client Health Behaviour and the associated principles of person-centred care were incorporated into a new model of care that was implemented in one radiation oncology setting in Brisbane, Australia. The new model of care was operationalised through a Primary Nursing/Collaborative Practice framework. To evaluate the impact of the new model for patients and health professionals, multiple sources of data were collected from patients and clinical staff prior to, during, and 18 months following introduction of the practice redesign. One cohort of patients and clinical staff completed surveys incorporating measures of key outcomes immediately prior to implementation of the model, while a second cohort of patients and clinical staff completed these same surveys 18 months following introduction of the model. In-depth interviews were also conducted with nursing, medical and allied health staff throughout the implementation phase to obtain a more comprehensive account of the processes and outcomes associated with implementing such a model. From the patients’ perspectives, this study demonstrated that, although adverse effects of radiotherapy continue to affect patient well-being, patients continue to be satisfied with nursing care in this specialty, and that they generally reported high levels of functioning despite undergoing a curative course of radiotherapy. From the health professionals’ perspective, there was evidence of attitudinal change by nursing staff within the radiotherapy department which reflected a greater understanding and appreciation of a more person-centred approach to care. Importantly, this case study has also confirmed that a range of factors need to be considered when redesigning nursing practice in the radiotherapy setting, as the challenges associated with changing traditional practices, ensuring multidisciplinary approaches to care, and resourcing a new model were experienced. The findings from this study suggest that the move from a relatively functional approach to a person-centred approach in the radiotherapy setting has contributed to some improvements in the provision of individualised and coordinated patient care. However, this study has also highlighted that primary nursing may be limited in its approach as a framework for patient care unless it is supported by a whole team approach, an appropriate supportive governance model, and sufficient resourcing. Introducing such a model thus requires effective education, preparation and ongoing support for the whole team. The challenges of providing care in the context of complex interdisciplinary relationships have been highlighted by this study. Aspects of this study may assist in planning further nursing interventions for patients undergoing radiotherapy for cancer, and continue to enhance the contribution of the radiation oncology nurse to improved patient outcomes.

A framework for improved adolescent and child safety in MMOs

This paper presents an approach to providing better safety for adolescents playing online games. We highlight an emerging paedophile presence in online games and offer a general framework for the design of monitoring and alerting tools. Our method is to monitor and detect relationships forming with a child in online games, and alert if the relationship indicates an offline meeting with the child has been arranged or has the potential to occur. A prototype implementation with demonstrative components of the framework has been created and is introduced. The prototype demonstration and evaluation uses a teen rated online relationship-building environment for its case study, specifically the predominant Massive Multiplayer Online Game (MMO) World of Warcraft.

Construction, application and validation of selection evaluation model (SEM) for intelligent HVAC control system

Design teams are confronted with the quandary of choosing apposite building control systems to suit the needs of particular intelligent building projects, due to the availability of innumerable ‘intelligent’ building products and a dearth of inclusive evaluation tools. This paper is organised to develop a model for facilitating the selection evaluation for intelligent HVAC control systems for commercial intelligent buildings. To achieve these objectives, systematic research activities have been conducted to first develop, test and refine the general conceptual model using consecutive surveys; then, to convert the developed conceptual framework into a practical model; and, finally, to evaluate the effectiveness of the model by means of expert validation. The results of the surveys are that ‘total energy use’ is perceived as the top selection criterion, followed by the‘system reliability and stability’, ‘operating and maintenance costs’, and ‘control of indoor humidity and temperature’. This research not only presents a systematic and structured approach to evaluate candidate intelligent HVAC control system against the critical selection criteria (CSC), but it also suggests a benchmark for the selection of one control system candidate against another.

Sustainable urban development : formulation of indicator-based residential sustainability assessment framework for local level

Purpose–The purpose of this paper is to formulate a conceptual framework for urban sustainability indicators selection. This framework will be used to develop an indicator-based evaluation method for assessing the sustainability levels of residential neighbourhood developments in Malaysia. Design/methodology/approach–We provide a brief overview of existing evaluation frameworks for sustainable development assessment. We then develop a conceptual Sustainable Residential Neighbourhood Assessment (SNA) framework utilising a four-pillar sustainability framework (environmental, social, economic and institutional) and a combination of domain-based and goal-based general frameworks. This merger offers the advantages of both individual frameworks, while also overcoming some of their weaknesses when used to develop the urban sustainability evaluation method for assessing residential neighbourhoods. Originality/value–This approach puts in evidence that many of the existing frameworks for evaluating urban sustainability do not extend their frameworks to include assessing housing sustainability at a local level. Practical implications–It is expected that the use of the indicator-based Sustainable Neighbourhood Assessment framework will present a potential mechanism for planners and developers to evaluate and monitor the sustainability performance of residential neighbourhood developments.

Evaluation of accessibility for knowledge-based cities

Purpose: The purpose of the paper is to develop a framework for evaluation of accessibility for knowledge based cities. ----- ----- Design/methodology/approach: This approach notifies common mistakes and problems in accessibility assessment for knowledge cities. ----- ----- Originality/value: Accessibility plays a key role in transport sustainability and recognizes the crucial links between transport and sustainable goals like air quality, environmental resource consumption & social equity. In knowledge cities, accessibility has significant effects on quality of life and social equity by improving the mobility of people and goods. Accessibility also influences patterns of growth and economic health by providing access to land. Accessibility is not only one of the components of knowledge cities but also affects other elements of knowledge cities directly or indirectly. ----- ----- Practical implications: The outcomes of the application will be helpful for developing particular methodologies for evaluating knowledge cities. On other words, this methodology attempts to develop an assessment procedure for examining accessibility of knowledge-based cities.

A framework for reasoning about inherent parallelism in modern object-oriented languages

With the emergence of multi-core processors into the mainstream, parallel programming is no longer the specialized domain it once was. There is a growing need for systems to allow programmers to more easily reason about data dependencies and inherent parallelism in general purpose programs. Many of these programs are written in popular imperative programming languages like Java and C]. In this thesis I present a system for reasoning about side-effects of evaluation in an abstract and composable manner that is suitable for use by both programmers and automated tools such as compilers. The goal of developing such a system is to both facilitate the automatic exploitation of the inherent parallelism present in imperative programs and to allow programmers to reason about dependencies which may be limiting the parallelism available for exploitation in their applications. Previous work on languages and type systems for parallel computing has tended to focus on providing the programmer with tools to facilitate the manual parallelization of programs; programmers must decide when and where it is safe to employ parallelism without the assistance of the compiler or other automated tools. None of the existing systems combine abstraction and composition with parallelization and correctness checking to produce a framework which helps both programmers and automated tools to reason about inherent parallelism. In this work I present a system for abstractly reasoning about side-effects and data dependencies in modern, imperative, object-oriented languages using a type and effect system based on ideas from Ownership Types. I have developed sufficient conditions for the safe, automated detection and exploitation of a number task, data and loop parallelism patterns in terms of ownership relationships. To validate my work, I have applied my ideas to the C] version 3.0 language to produce a language extension called Zal. I have implemented a compiler for the Zal language as an extension of the GPC] research compiler as a proof of concept of my system. I have used it to parallelize a number of real-world applications to demonstrate the feasibility of my proposed approach. In addition to this empirical validation, I present an argument for the correctness of the type system and language semantics I have proposed as well as sketches of proofs for the correctness of the sufficient conditions for parallelization proposed.

Strategic alliances in building construction : a tender evaluation tool for the public sector

Building construction is a highly competitive and risky business. This competitiveness is compounded where conflicting objectives amongst contracting and subcontracting firms set the stage for an adversarial and potentially destructive business relationship. Clients, especially those from the public sector, need broader tender evaluation criteria to complement the traditional focus on bid price. There is also a need for change in the construction industry—not only to a more cooperative approach between the constructing parties—but also from a confrontationist attitude to a more harmonious relationship between all stakeholders in providing constructed facilities. A strategic alliance is a cooperative relationship between two or more organisations that forms part of their overall strategies, and contributes to achieving their major goals and objectives. Strategic alliances in building construction may provide a useful tool to assist public sector construction managers evaluate tenders and concurrently encourage more cooperative relationships amongst construction stakeholders. This paper begins with an overview of the Australian building construction industry, then reviews the existing strategic alliance literature and describes an analysis framework comprising six attributes of strategic alliances for application to construction organisations—trust, commitment, interdependence, cooperation, communication, and joint problem solving. These attributes are currently being used to collect data from 70 building construction firms in Queensland to assess their respective levels of strategic alliance. Given the trend towards broader indicators of construction firm performance, these attributes are proposed as a tool for use in the tender evaluation process for public works.

Design education online : learning delivery and evaluation

Online learning has been recognised as an effective pedagogical method and tool, and is broadly integrated into various types of teaching and learning strategies in higher education. In practice, the use of Virtual Learning Environment (VLE) in higher education has become an integral strategy for quality education. The field of design education however has not been researched extensively in regard to online learning, delivery and evaluation. This paper discusses design education from an online learning perspective. It proposes an integrated framework with three key components for online learning via VLE including an interactive delivery structure, communication channels, and learning evaluation. Additionally, the paper describes and evaluates how VLE sites for two design units were built based on an integrated framework and student learning experiences. The results indicate that online design education should be integrated with various educational values and functional features in a systematic manner, and requires designing learning evaluation protocols as part of learning activities and communicative forms within online-based learning sites.

Test and evaluation system for multi-protocol sampled value protection schemes

Proposed transmission smart grids will use a digital platform for the automation of substations operating at voltage levels of 110 kV and above. The IEC 61850 series of standards, released in parts over the last ten years, provide a specification for substation communications networks and systems. These standards, along with IEEE Std 1588-2008 Precision Time Protocol version 2 (PTPv2) for precision timing, are recommended by the both IEC Smart Grid Strategy Group and the NIST Framework and Roadmap for Smart Grid Interoperability Standards for substation automation. IEC 61850-8-1 and IEC 61850-9-2 provide an inter-operable solution to support multi-vendor digital process bus solutions, allowing for the removal of potentially lethal voltages and damaging currents from substation control rooms, a reduction in the amount of cabling required in substations, and facilitates the adoption of non-conventional instrument transformers (NCITs). IEC 61850, PTPv2 and Ethernet are three complementary protocol families that together define the future of sampled value digital process connections for smart substation automation. This paper describes a specific test and evaluation system that uses real time simulation, protection relays, PTPv2 time clocks and artificial network impairment that is being used to investigate technical impediments to the adoption of SV process bus systems by transmission utilities. Knowing the limits of a digital process bus, especially when sampled values and NCITs are included, will enable utilities to make informed decisions regarding the adoption of this technology.

Loculus : an ontology-based information management framework for the motion picture industry

"How do you film a punch?" This question can be posed by actors, make-up artists, directors and cameramen. Though they can all ask the same question, they are not all seeking the same answer. Within a given domain, based on the roles they play, agents of the domain have different perspectives and they want the answers to their question from their perspective. In this example, an actor wants to know how to act when filming a scene involving a punch. A make-up artist is interested in how to do the make-up of the actor to show bruises that may result from the punch. Likewise, a director wants to know how to direct such a scene and a cameraman is seeking guidance on how best to film such a scene. This role-based difference in perspective is the underpinning of the Loculus framework for information management for the Motion Picture Industry. The Loculus framework exploits the perspective of agent for information extraction and classification within a given domain. The framework uses the positioning of the agent’s role within the domain ontology and its relatedness to other concepts in the ontology to determine the perspective of the agent. Domain ontology had to be developed for the motion picture industry as the domain lacked one. A rule-based relatedness score was developed to calculate the relative relatedness of concepts with the ontology, which were then used in the Loculus system for information exploitation and classification. The evaluation undertaken to date have yielded promising results and have indicated that exploiting perspective can lead to novel methods of information extraction and classifications.

Intrusion detection framework for encrypted networks

Network-based Intrusion Detection Systems (NIDSs) monitor network traffic for signs of malicious activities that have the potential to disrupt entire network infrastructures and services. NIDS can only operate when the network traffic is available and can be extracted for analysis. However, with the growing use of encrypted networks such as Virtual Private Networks (VPNs) that encrypt and conceal network traffic, a traditional NIDS can no longer access network traffic for analysis. The goal of this research is to address this problem by proposing a detection framework that allows a commercial off-the-shelf NIDS to function normally in a VPN without any modification. One of the features of the proposed framework is that it does not compromise on the confidentiality afforded by the VPN. Our work uses a combination of Shamir’s secret-sharing scheme and randomised network proxies to securely route network traffic to the NIDS for analysis. The detection framework is effective against two general classes of attacks – attacks targeted at the network hosts or attacks targeted at framework itself. We implement the detection framework as a prototype program and evaluate it. Our evaluation shows that the framework does indeed detect these classes of attacks and does not introduce any additional false positives. Despite the increase in network overhead in doing so, the proposed detection framework is able to consistently detect intrusions through encrypted networks.

Wellness education : an integrated theoretical framework for fostering transformative learning

Optimum Wellness involves the development, refinement and practice of lifestyle choices which resonate with personally meaningful frames of reference. Personal transformations are the means by which our frames of reference are refined across the lifespan. It is through critical reflection, supportive relationships and meaning making of our experiences that we construct and reconstruct our life paths. When individuals are able to be what they are destined to be or reach their higher purpose, then they are able to contribute to the world in positive and meaningful ways. Transformative education facilitates the changes in perspective that enable one to contemplate and travel a path in life that leads to self-actualisation. This thesis argues for an integrated theoretical framework for optimum Wellness Education. It establishes a learner centred approach to Wellness education in the form of an integrated instructional design framework derived from both Wellness and Transformative education constructs. Students’ approaches to learning and their study strategies in a Wellness education context serve to highlight convergences in the manner in which students can experience perspective transformation. As they learn to critically reflect, pursue relationships and adapt their frames of reference to sustain their pursuit of both learning and Wellness goals, strengthening the nexus between instrumental and transformative learning is a strategically important goal for educators. The aim of this exploratory research study was to examine those facets that serve to optimise the learning experiences of students in a Wellness course. This was accomplished through three research issues: 1) What are the relationships between Wellness, approaches to learning and academic success? 2) How are students approaching learning in an undergraduate Wellness subject? Why are students approaching their learning in the ways they do? 3) What sorts of transformations are students experiencing in their Wellness? How can transformative education be formulated in the context of an undergraduate Wellness subject? Subsequent to a thorough review of the literature pertaining to Wellness education, a mixed method embedded case study design was formulated to explore the research issues. This thesis examines the interrelationships between student, content and context in a one semester university undergraduate unit (a coherent set of learning activities which is assigned a unit code and a credit point value). The experiences of a cohort of 285 undergraduate students in a Wellness course formed the unit of study and seven individual students from a total of sixteen volunteers whose profiles could be constructed from complete data sets were selected for analysis as embedded cases. The introductory level course required participants to engage in a personal project involving a behaviour modification plan for a self-selected, single dimension of Wellness. Students were given access to the Standard Edition Testwell Survey to assess and report their Wellness as a part of their personal projects. To identify relationships among the constructs of Self-Regulated Learning (SRL), Wellness and Student Approaches to Learning (SAL) a blend of quantitative and qualitative methods to collect and analyse data was formulated. Surveys were the primary instruments for acquiring quantitative data. Sources included the Wellness data from Testwell surveys, SAL data from R-SPQ surveys, SRL data from MSLQ surveys and student self-evaluation data from an end of semester survey. Students’ final grades and GPA scores were used as indicators of academic performance. The sources of qualitative data included subject documentation, structured interview transcripts and open-ended responses to survey items. Subsequent to a pilot study in which survey reliability and validity were tested in context, amendments to processes for and instruments of data collection were made. Students who adopted meaning oriented (deep/achieving) approaches tended to assess their Wellness at a higher level, seek effective learning strategies and perform better in formal study. Posttest data in the main study revealed that there were significant positive statistical relationships between academic performance and total wellness scores (rs=.297, n=205, p<.01). Deep (rs=.343, n=137, p<.01) and achieving (rs=.286, n=123, p<.01) approaches to learning also significantly correlated with Wellness whilst surface approaches had negative correlations that were not significant. SRL strategies including metacognitive selfregulation, effort, help-seeking and critical thinking were increasingly correlated with Wellness. Qualitative findings suggest that while all students adopt similar patterns of day to day activities for example attending classes, taking notes, working on assignments the level of care with which these activities is undertaken varies considerably. The dominant motivational trigger for students in this cohort was the personal relevance and associated benefits of the material being learned and practiced. Students were inclined to set goals that had a positive impact on affect and used “sense of happiness” to evaluate their achievement status. Students who had a higher drive to succeed and/or understand tended to have or seek a wider range of strategies. Their goal orientations were generally learning rather than performance based and barriers presented a challenge which could be overcome as opposed to a blockage which prevented progress. Findings from an empirical analysis of the Testwell data suggest that a single third order Wellness construct exists. A revision of the instrument is necessary in order to juxtapose it with the chosen six dimensional Wellness model that forms the foundation construct in the course. Further, redevelopment should be sensitive to the Australian context and culture including choice of language, examples and scenarios used in item construction. This study concludes with an heuristic for use in Wellness education. Guided by principles of Transformative education theory and behaviour change theory, and informed by this representative case study the “CARING” heuristic is proposed as an instructional design tool for Wellness educators seeking to foster transformative learning. Based upon this study, recommendations were made for university educators to provide authentic and personal experiences in Wellness curricula. Emphasis must focus on involving students and teachers in a partnership for implementing Wellness programs both in the curriculum and co-curricularly. The implications of this research for practice are predicated on the willingness of academics to embrace transformative learning at a personal level and a professional one. To explore students’ profiles in detail is not practical however teaching students how to guide us in supporting them through the “pain” of learning is a skill which would benefit them and optimise the learning and teaching process. At a theoretical level, this research contributes to an ecological theory of Wellness education as transformational change. By signposting the wider contexts in which learning takes place, it seeks to encourage changing paradigms to ones which harness the energy of each successive contextual layer in which students live. Future research which amplifies the qualities of individuals and groups who are “Well” and seeks the refinement and development of instruments to measure Wellness constructs would be desirable for both theoretical and applied knowledge bases. Mixed method Wellness research derived and conducted by teams that incorporate expertise from multiple disciplines such as psychology, anthropology, education, and medicine would enable creative and multi-perspective programs of investigation to be designed and implemented. Congruences and inconsistencies in health promotion and education would provide valuable material for strengthening the nexus between transformational learning and behaviour change theories. Future development of and research on the effectiveness of the CARING heuristic would be valuable in advancing the understanding of pedagogies which advance rather than impede learning as a transformative process. Exploring pedagogical models that marry with transformative education may render solutions to the vexing challenge of teaching and learning in diverse contexts.

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.

A framework for analysing system intelligence of the building control system: a study of the integrated building management system

The lack of satisfactory consensus for characterizing the system intelligence and structured analytical decision models has inhibited the developers and practitioners to understand and configure optimum intelligent building systems in a fully informed manner. So far, little research has been conducted in this aspect. This research is designed to identify the key intelligent indicators, and develop analytical models for computing the system intelligence score of smart building system in the intelligent building. The integrated building management system (IBMS) was used as an illustrative example to present a framework. The models presented in this study applied the system intelligence theory, and the conceptual analytical framework. A total of 16 key intelligent indicators were first identified from a general survey. Then, two multi-criteria decision making (MCDM) approaches, the analytic hierarchy process (AHP) and analytic network process (ANP), were employed to develop the system intelligence analytical models. Top intelligence indicators of IBMS include: self-diagnostic of operation deviations; adaptive limiting control algorithm; and, year-round time schedule performance. The developed conceptual framework was then transformed to the practical model. The effectiveness of the practical model was evaluated by means of expert validation. The main contribution of this research is to promote understanding of the intelligent indicators, and to set the foundation for a systemic framework that provide developers and building stakeholders a consolidated inclusive tool for the system intelligence evaluation of the proposed components design configurations.

Understanding evaluation of learning support in mathematics and statistics

With rapid and continuing growth of learning support initiatives in mathematics and statistics found in many parts of the world, and with the likelihood that this trend will continue, there is a need to ensure that robust and coherent measures are in place to evaluate the effectiveness of these initiatives. The nature of learning support brings challenges for measurement and analysis of its effects. After briefly reviewing the purpose, rationale for, and extent of current provision, this article provides a framework for those working in learning support to think about how their efforts can be evaluated. It provides references and specific examples of how workers in this field are collecting, analysing and reporting their findings. The framework is used to structure evaluation in terms of usage of facilities, resources and services provided, and also in terms of improvements in performance of the students and staff who engage with them. Very recent developments have started to address the effects of learning support on the development of deeper approaches to learning, the affective domain and the development of communities of practice of both learners and teachers. This article intends to be a stimulus to those who work in mathematics and statistics support to gather even richer, more valuable, forms of data. It provides a 'toolkit' for those interested in evaluation of learning support and closes by referring to an on-line resource being developed to archive the growing body of evidence. © 2011 Taylor & Francis.