On model typing

Where object-oriented languages deal with objects as described by classes, model-driven development uses models, as graphs of interconnected objects, described by metamodels. A number of new languages have been and continue to be developed for this model- based paradigm, both for model transformation and for general programming using models. Many of these use single-object approaches to typing, derived from solutions found in object-oriented systems, while others use metamodels as model types, but without a clear notion of polymorphism. Both of these approaches lead to brittle and overly restrictive reuse characteristics. In this paper we propose a simple extension to object-oriented typing to better cater for a model-oriented context, including a simple strategy for typing models as a collection of interconnected objects. We suggest extensions to existing type system formalisms to support these concepts and their manipulation. Using a simple example we show how this extended approach permits more flexible reuse, while preserving type safety.

Using digital rights management for securing data in a medical research environment

We propose a digital rights management approach for sharing electronic health records in a health research facility and argue advantages of the approach. We also give an outline of the system under development and our implementation of the security features and discuss challenges that we faced and future directions.

Across-country comparisons of selected infant and young child feeding indicators and associated factors in four South Asian countries

Background: Information on infant and young child feeding is widely available in Demographic and Health Surveys and National Family Health Surveys for countries in South Asia; however, infant and young child feeding indicators from these surveys have not been compared between countries in the region. Objective. To compare the key indicators of breastfeeding and complementary feeding and their determinants in children under 24 months of age between four South Asian countries. Methods: We selected data sets from the Bangladesh Demographic and Health Survey 2004, the India National Family Health Survey (NFHS-03) 2005–06, the Nepal Demographic and Health Survey 2006, and the Sri Lanka 2000 Demographic and Health Survey. Infant feeding indicators were estimated according to the key World Health Organization indicators. Results: Exclusive breastfeeding rates were 42.5% in Bangladesh, 46.4% in India, and 53.1% in Nepal. The rate of full breastfeeding ranged between 60.6% and 73.9%. There were no factors consistently associated with the rate of no exclusive breastfeeding across countries. Utilization of health services (more antenatal clinic visits) was associated with higher rates of exclusive breastfeeding in India but lower rates in Nepal. Delivery at a health facility was a negative determinant of exclusive breastfeeding in India. Postnatal contacts by Public Health Midwives were a positive factor in Sri Lanka. A considerable proportion of infants under 6 months of age had been given plain water, juices, or other nonmilk liquids. The rate of timely first suckling ranged from 23.5% in India to 56.3% in Sri Lanka. Delivery by cesarean section was found to be a consistent negative factor that delayed initiation of breastfeeding. Nepal reported the lowest bottle-feeding rate of 3.5%. Socioeconomically privileged mothers were found to have higher bottlefeeding rates in most countries. Conclusions: Infant and young child feeding practices in the South Asia region have not reached the expected levels that are required to achieve a substantial reduction in child mortality. The countries with lower rates of exclusive breastfeeding have a great potential to improve the rates by preventing infants from receiving water and water-based or other nonmilk liquids during the first 6 months of life.

Infant and young child feeding indicators and determinants of poor feeding practices in India : secondary data analysis of National Family Health Survey 2005–06

Background: In India, poor feeding practices in early childhood contribute to the burden of malnutrition and infant and child mortality. Objective. To estimate infant and young child feeding indicators and determinants of selected feeding practices in India. Methods: The sample consisted of 20,108 children aged 0 to 23 months from the National Family Health Survey India 2005–06. Selected indicators were examined against a set of variables using univariate and multivariate analyses. Results: Only 23.5% of mothers initiated breastfeeding within the first hour after birth, 99.2% had ever breastfed their infant, 89.8% were currently breastfeeding, and 14.8% were currently bottle-feeding. Among infants under 6 months of age, 46.4% were exclusively breastfed, and 56.7% of those aged 6 to 9 months received complementary foods. The risk factors for not exclusively breastfeeding were higher household wealth index quintiles (OR for richest = 2.03), delivery in a health facility (OR = 1.35), and living in the Northern region. Higher numbers of antenatal care visits were associated with increased rates of exclusive breastfeeding (OR for ≥ 7 antenatal visits = 0.58). The rates of timely initiation of breastfeeding were higher among women who were better educated (OR for secondary education or above = 0.79), were working (OR = 0.79), made more antenatal clinic visits (OR for ≥ 7 antenatal visits = 0.48), and were exposed to the radio (OR = 0.76). The rates were lower in women who were delivered by cesarean section (OR = 2.52). The risk factors for bottle-feeding included cesarean delivery (OR = 1.44), higher household wealth index quintiles (OR = 3.06), working by the mother (OR=1.29), higher maternal education level (OR=1.32), urban residence (OR=1.46), and absence of postnatal examination (OR=1.24). The rates of timely complementary feeding were higher for mothers who had more antenatal visits (OR=0.57), and for those who watched television (OR=0.75). Conclusions: Revitalization of the Baby Friendly Hospital Initiative in health facilities is recommended. Targeted interventions may be necessary to improve infant feeding practices in mothers who reside in urban areas, are more educated, and are from wealthier households.

Research and application of Building Information Modelling (BIM) in the Architecture, Engineering and Construction (AEC) industry : a review and direction for future research

With an increasing level of collaboration amongst researchers, software developers and industry practitioners in the past three decades, building information modelling (BIM) is now recognized as an emerging technological and procedural shift within the architect, engineering and construction (AEC) industry. BIM is not only considered as a way to make a profound impact on the professions of AEC, but is also regarded as an approach to assist the industry to develop new ways of thinking and practice. Despite the widespread development and recognition of BIM, a succinct and systematic review of the existing BIM research and achievement is scarce. It is also necessary to take stock on existing applications and have a fresh look at where BIM should be heading and how it can benefit from the advances being made. This paper first presents a review of BIM research and achievement in AEC industry. A number of suggestions are then made for future research in BIM. This paper maintains that the value of BIM during design and construction phases is well documented over the last decade, and new research needs to expand the level of development and analysis from design/build stage to postconstruction and facility asset management. New research in BIM could also move beyond the traditional building type to managing the broader range of facilities and built assets and providing preventative maintenance schedules for sustainable and intelligent buildings

Passenger flow and station facilities modelling for metro station layout design

This paper presents the simulation model development of passenger flow in a metro station. The model allows studies of passenger flow in stations with different layouts and facilities, thus providing valuable information, such as passenger flow and density of passenger at critical locations and passenger-handling facilities within a station, to the operators. The adoption of the concept of Petri nets in the simulation model is discussed. Examples are provided to demonstrate its application to passenger flow analysis, train scheduling and the testing of alternative station layouts.

Benchmarking clinical indicators of quality for Australian residential aged care facilities

To undertake exploratory benchmarking of a set of clinical indicators of quality care in residential care in Australia, data were collected from 107 residents within four medium-sized facilities (40–80 beds) in Brisbane, Australia. The proportion of residents in each sample facility with a particular clinical problem was compared with US Minimum Data Set quality indicator thresholds. Results demonstrated variability within and between clinical indicators, suggesting breadth of assessment using various clinical indicators of quality is an important factor when monitoring quality of care. More comprehensive and objective measures of quality of care would be of great assistance in determining and monitoring the effectiveness of residential aged care provision in Australia, particularly as demands for accountability by consumers and their families increase. What is known about the topic? The key to quality improvement is effective quality assessment, and one means of evaluating quality of care is through clinical outcomes. The Minimum Data Set quality indicators have been credited with improving quality in United States nursing homes. What does this paper add? The Clinical Care Indicators Tool was used to collect data on clinical outcomes, enabling comparison of data from a small Australian sample with American quality benchmarks to illustrate the utility of providing guidelines for interpretation. What are the implications for practitioners? Collecting and comparing clinical outcome data would enable practitioners to better understand the quality of care being provided and whether practices required review. The Clinical Care Indicator Tool could provide a comprehensive and systematic means of doing this, thus filling a gap in quality monitoring within Australian residential aged care.

Iron burning in pressurised oxygen under microgravity conditions

An investigation of cylindrical iron rods burning in pressurised oxygen under microgravity conditions is presented. It has been shown that, under similar experimental conditions, the melting rate of a burning, cylindrical iron rod is higher in microgravity than in normal gravity by a factor of 1.8 ± 0.3. This paper presents microanalysis of quenched samples obtained in a microgravity environment in a 2.0 s duration drop tower facility in Brisbane, Australia. These images indicate that the solid/liquid interface is highly convex in reduced gravity, compared to the planar geometry typically observed in normal gravity, which increases the contact area between liquid and solid phases by a factor of 1.7 ± 0.1. Thus, there is good agreement between the proportional increase in solid/liquid interface surface area and melting rate in microgravity. This indicates that the cause of the increased melting rates for cylindrical iron rods burning in microgravity is altered interfacial geometry at the solid/liquid interface.

Impacts and adaptation response of infrastructure and communities to heatwaves : the southern Australian experience of 2009

From 27 January to 8 February during the summer of 2009, southern Australia experienced one of the nation‘s most severe heatwaves. Governments, councils, utilities, hospitals and emergency response organisations and the community were largely underprepared for an extreme event of this magnitude. This case study targets the experience and challenges faced by decision makers and policy makers and focuses on the major metropolitan areas affected by the heatwave — Melbourne and Adelaide. The study examines the 2009 heatwave‘s characteristics; its impacts (on human health, infrastructure and human services); the degree of adaptive capacity (vulnerability and resilience) of various sectors, communities and individuals; and the reactive responses of government and emergency and associated services and their effectiveness. Barriers and challenges to adaptation and increasing resilience are also identified and further areas for research are suggested. This study does not include details of the heatwave‘s effects beyond Victoria and South Australia, or its economic impacts, or of Victoria‘s 'Black Saturday‘ bushfires.

Clinical outcomes in residential care : setting benchmarks for quality

Aim Australian residential aged care does not have a system of quality assessment related to clinical outcomes, or comprehensive quality benchmarking. The Residential Care Quality Assessment was developed to fill this gap; and this paper discusses the process by which preliminary benchmarks representing high and low quality were developed for it. Methods Data were collected from all residents (n = 498) of nine facilities. Numerator–denominator analysis of clinical outcomes occurred at a facility-level, with rank-ordered results circulated to an expert panel. The panel identified threshold scores to indicate excellent and questionable care quality, and refined these through Delphi process. Results Clinical outcomes varied both within and between facilities; agreed thresholds for excellent and poor outcomes were finalised after three Delphi rounds. Conclusion Use of the Residential Care Quality Assessment provides a concrete means of monitoring care quality and allows benchmarking across facilities; its regular use could contribute to improved care outcomes within residential aged care in Australia.

Differences in Treatment and Management of Indigenous and Non-Indigenous Patients Presenting with Chest Pain: Results of the Heart Protection Partnership (HPP) Study

BACKGROUND: Indigenous patients with acute coronary syndromes represent a high-risk group. There are however few contemporary datasets addressing differences in the presentation and management of Indigenous and non-Indigenous patients with chest pain. METHODS: The Heart Protection Project, is a multicentre retrospective audit of consecutive medical records from patients presenting with chest pain. Patients were identified as Indigenous or non-Indigenous, and time to presentation and cardiac investigations as well as rates of cardiac investigations and procedures were compared between the two groups. RESULTS: Of the 2380 patients included, 199 (8.4%) identified as Indigenous, and 2174 (91.6%) as non-Indigenous. Indigenous patients were younger, had higher rates hyperlipidaemia, diabetes, smoking, known coronary artery disease and a lower rate of prior PCI; and were significantly less likely to have private health insurance, be admitted to an interventional facility or to have a cardiologist as primary physician. Following adjustment for difference in baseline characteristics, Indigenous patients had comparable rates of cardiac investigations and delay times to presentation and investigations. CONCLUSIONS: Although the Indigenous population was identified as a high-risk group, in this analysis of selected Australian hospitals there were no significant differences in treatment or management of Indigenous patients in comparison to non-Indigenous.

Constructing leadership in child care : epistemological beliefs and transformational leadership

Early childhood education and care (ECEC) in Australia are currently a focus of social and economic policy. However, early childhood leadership in Australia is yet to develop a clear identity that will enable the field to develop to its full potential. In this paper we investigate a unique theoretical framework for constructing leadership identity, based on transformational leadership and epistemological beliefs. Using semistructured interviews, 15 childcare directors from a large metropolitan area in Australia were asked to describe their beliefs about knowing in the context of their leadership practices. The findings showed that leaders (n = 5) who espoused predominantly evaluativist beliefs about knowing were more likely to describe transformational leadership behaviours in the context of childcare leadership. A number of leaders held mixed beliefs (n = 9) about knowing and described their leadership practice in ways that reflected both transactional and transformational leadership styles. Finally, one leader described predominantly objectivist epistemological beliefs and transactional beliefs about leadership. These preliminary findings show that there seems to be a relationship between core epistemological beliefs and beliefs about leadership practices and offers a new way to characterise leadership in ECEC in Australia.

Response shift, recall bias and their effect on measuring change in health-related quality of life amongst older hospital patients

Background: Assessments of change in subjective patient reported outcomes such as health-related quality of life (HRQoL) are a key component of many clinical and research evaluations. However, conventional longitudinal evaluation of change may not agree with patient perceived change if patients' understanding of the subjective construct under evaluation changes over time (response shift) or if patients' have inaccurate recollection (recall bias). This study examined whether older adults' perception of change is in agreement with conventional longitudinal evaluation of change in their HRQoL over the duration of their hospital stay. It also investigated this level of agreement after adjusting patient perceived change for recall bias that patients may have experienced. Methods: A prospective longitudinal cohort design nested within a larger randomised controlled trial was implemented. 103 hospitalised older adults participated in this investigation at a tertiary hospital facility. The EQ-5D utility and Visual Analogue Scale (VAS) scores were used to evaluate HRQoL. Participants completed EQ-5D reports as soon as they were medically stable (within three days of admission) then again immediately prior to discharge. Three methods of change score calculation were used (conventional change, patient perceived change and patient perceived change adjusted for recall bias). Agreement was primarily investigated using intraclass correlation coefficients (ICC) and limits of agreement. Results: Overall 101 (98%) participants completed both admission and discharge assessments. The mean (SD) age was 73.3 (11.2). The median (IQR) length of stay was 38 (20-60) days. For agreement between conventional longitudinal change and patient perceived change: ICCs were 0.34 and 0.40 for EQ-5D utility and VAS respectively. For agreement between conventional longitudinal change and patient perceived change adjusted for recall bias: ICCs were 0.98 and 0.90 respectively. Discrepancy between conventional longitudinal change and patient perceived change was considered clinically meaningful for 84 (83.2%) of participants, after adjusting for recall bias this reduced to 8 (7.9%). Conclusions: Agreement between conventional change and patient perceived change was not strong. A large proportion of this disagreement could be attributed to recall bias. To overcome the invalidating effect of response shift (on conventional change) and recall bias (on patient perceived change) a method of adjusting patient perceived change for recall bias has been described.

Contemporary take on deconstructed Medea : a review

THEATRE: The New Dead: Medea Material. By Heiner Muller. Stella Electrika in association with La Boite Theatre Company, Brisbane, November 19. THERE has been a lot of intensity in independent theatre in Brisbane during the past year, as companies, production houses and producers have begun building new programs and platforms to support an expansion of pathways within the local theatre ecology. Audiences have been exposed to works signalling the diversity of what Brisbane theatre makers want to see on stage, from productions of new local and international pieces to new devised works, and the results of residencies and development programs. La Boite Theatre Company closes its inaugural indie season with a work that places it at the contemporary, experimental end of the spectrum. The New Dead: Medea Material is emerging director Kat Henry's interpretation of Heiner Muller's 1981 text Despoiled Shore Medea Material Landscape with Argonauts. Start of sidebar. Skip to end of sidebar. End of sidebar. Return to start of sidebar. Muller is known for his radical adaptations of historical dramas, from the Greeks to Shakespeare, and for deconstructed texts in which the characters - in this case, Medea - violently reject the familial, cultural and political roles society has laid out for them. Muller's combination of deconstructed characters, disconnected poetic language and constant references to aspects of popular culture and the Cold War politics he sought to abjure make his texts challenging to realise. The poetry entices but the density, together with the increasing distance of the Cold War politics in the texts, leaves contemporary directors with clear decisions to make about how to adapt these open texts. In The New Dead: Medea Material, Henry works with some interesting imagery and conceptual territory. Lucinda Shaw as Medea, Guy Webster as Jason and Kimie Tsukakoshi as King Creon's daughter Glauce, the woman for whom Jason forsakes his wife Medea, each reference different aspects of contemporary culture. Medea is a bitter, drunken, satin-gowned diva with bite; Jason - first seen lounging in front of the television with a beer in an image reminiscent of Sarah Kane's in-yer-face characterisation of Hippolytus in Phaedra's Love - has something of the rock star about him; and Glauce is a roller-skating, karaoke-singing, pole-dancing young temptress. The production is given a contemporary tone, dominated by Medea's twisted love and loss, rather than by any commentary on her circumstances. Its strength is the aesthetic Henry creates, supported by live electro-pop music, a band stage that stands as a metaphor for Jason's sea voyage, and multimedia that inserts images of the story unfolding beyond these characters' speeches as sorts of subconscious flashes. While Tsukakoshi is engaging throughout, there are moments when Shaw and Webster's performances - particularly in the songs - are diminished by a lack of clarity. The result is a piece that, while slightly lacking in its realisation at times, undoubtedly flags Henry's facility as an emerging director and what she wants to bring to the Brisbane theatre scene.

Clinical indicators of quality for Australian residential aged care facilities : establishing reliability, validity, and quality thresholds

Background: In response to the need for more comprehensive quality assessment within Australian residential aged care facilities, the Clinical Care Indicator (CCI) Tool was developed to collect outcome data as a means of making inferences about quality. A national trial of its effectiveness and a Brisbane-based trial of its use within the quality improvement context determined the CCI Tool represented a potentially valuable addition to the Australian aged care system. This document describes the next phase in the CCI Tool.s development; the aims of which were to establish validity and reliability of the CCI Tool, and to develop quality indicator thresholds (benchmarks) for use in Australia. The CCI Tool is now known as the ResCareQA (Residential Care Quality Assessment). Methods: The study aims were achieved through a combination of quantitative data analysis, and expert panel consultations using modified Delphi process. The expert panel consisted of experienced aged care clinicians, managers, and academics; they were initially consulted to determine face and content validity of the ResCareQA, and later to develop thresholds of quality. To analyse its psychometric properties, ResCareQA forms were completed for all residents (N=498) of nine aged care facilities throughout Queensland. Kappa statistics were used to assess inter-rater and test-retest reliability, and Cronbach.s alpha coefficient calculated to determine internal consistency. For concurrent validity, equivalent items on the ResCareQA and the Resident Classification Scales (RCS) were compared using Spearman.s rank order correlations, while discriminative validity was assessed using known-groups technique, comparing ResCareQA results between groups with differing care needs, as well as between male and female residents. Rank-ordered facility results for each clinical care indicator (CCI) were circulated to the panel; upper and lower thresholds for each CCI were nominated by panel members and refined through a Delphi process. These thresholds indicate excellent care at one extreme and questionable care at the other. Results: Minor modifications were made to the assessment, and it was renamed the ResCareQA. Agreement on its content was reached after two Delphi rounds; the final version contains 24 questions across four domains, enabling generation of 36 CCIs. Both test-retest and inter-rater reliability were sound with median kappa values of 0.74 (test-retest) and 0.91 (inter-rater); internal consistency was not as strong, with a Chronbach.s alpha of 0.46. Because the ResCareQA does not provide a single combined score, comparisons for concurrent validity were made with the RCS on an item by item basis, with most resultant correlations being quite low. Discriminative validity analyses, however, revealed highly significant differences in total number of CCIs between high care and low care groups (t199=10.77, p=0.000), while the differences between male and female residents were not significant (t414=0.56, p=0.58). Clinical outcomes varied both within and between facilities; agreed upper and lower thresholds were finalised after three Delphi rounds. Conclusions: The ResCareQA provides a comprehensive, easily administered means of monitoring quality in residential aged care facilities that can be reliably used on multiple occasions. The relatively modest internal consistency score was likely due to the multi-factorial nature of quality, and the absence of an aggregate result for the assessment. Measurement of concurrent validity proved difficult in the absence of a gold standard, but the sound discriminative validity results suggest that the ResCareQA has acceptable validity and could be confidently used as an indication of care quality within Australian residential aged care facilities. The thresholds, while preliminary due to small sample size, enable users to make judgements about quality within and between facilities. Thus it is recommended the ResCareQA be adopted for wider use.